Fast-food restaurants pledged healthier options for kids. How have they done?

In 2013, amid warnings of a national child obesity epidemic and calls to improve children’s food options, some of America's most popular fast-food restaurants began promising healthier drinks and sides for kids.         

But have they followed through with those promises?

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Sort of, according to a report released Thursday by the Rudd Center for Food Policy and Obesity at the University of Connecticut.

McDonald’s promised in 2013 to remove soda advertising directed at children, only feature water, milk and juice as drink options on its Happy Meal menu boards and add new healthy options to the Happy Meal. That same year, KFC introduced the Li’l Bucket Kids Meal, which came with green beans, applesauce and flavored water. In 2014, Subway said it would only offer items that met strong nutritional guidelines on its kids’ menu.         

Burger King, Wendy’s and Dairy Queen all made similar pledges to promote and offer healthier children's drinks. 

Here’s the good news for public health advocates: In 2016, none of the chains’ websites listed sugary soda and other soft drinks on the kids’ menu. And online, they had all added at least one healthier drink to their kids' menus, such as juice, water or low-fat milk, and at least one healthier side dish, such as fresh fruit or yogurt.

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"At least now there is an option to get something that’s lower in sugar and calories for your child than you could before," said Jennifer Harris, lead author of the study and director of Marketing Initiatives at the Rudd Center.  "A lot of parents go to fast-food restaurants because it’s convenient, so if you’re going to do that, at least you can get something healthier for the (children)."         

But changes in the online menus did not always translate to real life. Harris’ team had “mystery shoppers” from an independent market research firm visit the chains’ restaurants. After hundreds of visits to restaurants across the country, they found one-third or more continued to list soda and other sugary drinks on their kids’ menu boards. They also found staff continued to offer soft drinks and soda with kids’ meal orders.

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Only 8 percent of restaurant staff at Burger King and 22 percent at Wendy’s offered healthier sides with their kids’ meals, though it should be noted these chains only committed to offering healthier drinks, not side options. McDonald’s did better, with 100 percent of staff offering healthier options, but since its kids’ meal comes with two sides, a second side of fries was usually automatically included as well.          

"They have added the healthier options ... but they are not really encouraging parents to purchase those options when they’re in the restaurants," Harris said. She thinks restaurants should make healthy drinks and sides the default with kids’ meals — and sugary drinks and fries should be an unlisted option.          

"We take our commitments seriously and have a rigorous process in place to monitor and evaluate the implementation across our restaurants," McDonald's said in a statement, adding that an independent verification firm has certified the company has complied with its health commitment.  

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A statement from Wendy's noted that menu boards do not feature carbonated beverages as a Kids' Meals option, but parents are asked for their beverage choice when ordering and can still order a soft drink if they so choose; Subway said its Fresh Fit for Kids' Meal includes four sandwiches with healthy components and low-fat milk or juice.     

The other chains did not immediately reply to a request for comment. 

Some nutrition professionals have expressed doubts about some of the so-called “healthy” drinks and sides offered at these chains, such as flavored milk. Burger King offers an 8-ounce 1 percent chocolate milk with its kids’ meals, which contains 160 calories and 25g of sugar. An equivalent 8-ounce can of original Coca-Cola has 100 calories and 26g of sugar.         

Wendy’s, KFC and McDonald’s all offer 1 percent chocolate milk with comparable calorie and sugar content. Dairy Queen and Subway do not serve flavored milk.         

"I’d suggest that children (and adults) choose water to drink ... another option would be skim/low-fat (plain) milk," said Rebecca Seguin, an associate professor in the Division of Nutritional Sciences at Cornell University’s College of Human Ecology, in an email. Low-fat plain milk is a kids’ beverage option at all six chains.

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The main dish items are still terribly unhealthy at fast-food restaurants, Harris said. Eating at home is a healthier option, but she understands many families go to fast-food restaurants for convenience and cost reasons. One-third of kids in the U.S. consume fast food each day, according to a 2012 American Journal of Preventive Medicine study, adding an approximate 126 calories each day to their daily intake.         

There are convenient, affordable options outside of fast food, according to Seguin.

Gas stations and convenience stores are doing a great job carrying healthy grab-and-go options now, Seguin said. Many stock bananas, apples, oranges and cut fruit, along with cut vegetables, nuts, cheese sticks, yogurt and whole grain sandwiches.         

And for those who have the time, she suggests packing simple snacks and meals at home.

"Whole or cut fruit, baby carrots and other snacking vegetables will travel well," she said. Cheese sticks, nuts and sandwiches — lean meat or jelly and nut-only peanut butter without added oils or fats on whole grain bread — are also good snacking and meal options.         

It’s important for parents to encourage healthy eating early on, according to Seguin.

"From an early age, (children) are developing what they like to eat and what they’re used to eating,” she said. “If we want to get them used to eating foods that are not very sugary, highly salty and processed, we need to start early."         

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