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CSPI Study Finds Few Healthy Kids Options At Chains

Boy-eating-burger-Shutterstock-ANew research from nutrition watchdog nonprofit the Center for Science in the Public Interest (CSPI) finds that there are few kids meal options at the nation’s top 50 chain restaurants that meet recommended nutritional standards for children in the preschool to elementary-school age range.  

Specifically, the study -- conducted by Ameena Batada, assistant professor in the Department of Health and Wellness at the University of North Carolina Asheville -- found that 97% of the nearly 3,500 children’s meal combinations offered by the top 50 (based on 2009 annual revenue) chains that were analyzable do not meet a set of nutritional standards for four- to-eight-year-olds that were adapted for CSPI by nutrition and health experts based on the National Alliance for Nutrition and Activity’s “Model Local School Wellness Policies on Physical Activity and Nutrition.” (Those standards were in turn based on key recommendations in USDA’s Dietary Guidelines for Americans.)

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In addition, the study found that 91% of those meal combinations do not meet the National Restaurant Association’s voluntary “Kids LiveWell” nutrition standards.

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 or 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 vegetables (including an item that is 51% or more whole grain, or including specified levels of vitamins or fiber). CSPI’s criteria exclude sugar-added drinks in favor of water, juice or lowfat milk. 

CSPI used the same set of nutritional standards for the current study that were used in a study it conducted in 2008, so that progress could be assessed.

According to CSPI, the NRA’s standards are quite similar, although the NRA’s allow more calories (600 calories per meal). (See CSPI’s full report for methodology, key differences in the two sets of nutritional standards and other details.)

CSPI reports that among the top 50 chains, nine (18%) did not have dedicated children’s menu items or meals: Domino’s Pizza, Dunkin' Donuts, 7-Eleven, Papa John's, Golden Corral, Church’s Chicken, Little Caesars Pizza, HomeTown Buffet/Old Country Buffet and Starbucks. 

Of the 41 chains with children's items, 34 (83%) offered children’s meal combinations and also provided adequate information for nutrition analyses. Those combinations were the 3,498 meals assessed against the two sets of standards in the study.

Commenting on the research, CSPI nutrition policy director Margo G. Wootan asserted: “One out of every three American children is overweight or obese, but it’s as if the chain restaurant industry didn’t get the memo. Most chains seem stuck in a time warp, serving up the same old meals based on chicken nuggets, burgers, macaroni and cheese, fries and soda.”

However, CSPI did find some progress. In 2008, 1% of kids meals met CSPI’s nutrition standards, compared with 3% in 2012. Only one-third of the restaurant chains had at least one meal that met CSPI’s nutritional standards in 2008; that percentage climbed to 44% in 2012. While more meals met CSPI’s sodium and calorie standards, fewer met its limit for saturated fat.

Of the chains with kids meals that were analyzable for nutrition content, CSPI reports that Subway is by far the leader in offering healthy options: All eight of its Fresh Fit for Kids meal combinations (100% of their options) met both CSPI’s and NRA’s Kids LiveWell standards. Subway is the only restaurant chain among those analyzed 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, according to CSPI. (Although CSPI notes that even Subway should work to increase the whole grain content of its breads and continue to lower sodium content.)

Twenty-four other chains have at least some kids meal options that meet the NRA’s Kids LiveWell standards (between 2% and 50% of each of these chains’ kids options met those standards—see chart in CSPI report).

Fourteen other chains have some kids meal options that meet CSPI’s standards (between 1% and 31% of each of these chains’ kids options met those standards). 

The study reports that Applebee’s, Chili’s, Denny’s, Ruby Tuesday’s and Dairy Queen each offer one, specific kids meal combination assessed as being among the “least healthy.” 

The CSPI report recommends that chains consider several changes. It encourages chains to participate in NRA’s Kids LiveWell program, and to reformulate their kids meals to meet those standards. It states that restaurants should offer more fruit and vegetable options and make those, rather than French fries, the default sides; offer more whole grains; and remove soda or other sugar-added drinks from kids menus.

In response to the study, the NRA issued the following statement: “Restaurants nationwide are providing innovative, healthful children’s options to their young guests. One way restaurants are offering healthful kids meals is through [NRA’s] Kids LiveWell program, which is a first-of-its-kind, voluntary initiative that helps parents and children select healthful menu options when dining out at nearly 40,000 locations nationwide. “The program, now with more than 120 restaurant brands, has achieved significant momentum in just 18 short months since first launching with 19 inaugural leaders. Participating restaurants offer and promote healthful meals for children that focus on increasing consumption of fruits and vegetables, lean protein, whole grains and low-fat dairy, while limiting unhealthful fats, sugars and sodium. The items meet strict nutrition criteria based on leading health organizations' scientific recommendations, including the USDA Dietary Guidelines.”

The association reports that the first restaurants in the Kids LiveWell program offer a total of 342 healthful children’s menu items, including 390 servings of fruit and vegetables, 144 servings of lean protein, 70 servings of low-fat dairy and 48 servings of whole grain. 

NRA also points out that healthful kids meals are the #3 restaurant food trend in 2013 for both full-service and limited-service restaurants. Children’s nutrition and whole grain items for kids meals ranked in the top 10 of NRA’s “What’s Hot in 2013” chef survey for full-service. Other top trends in the limited-service segment include fruit and vegetable side items and low-fat or nonfat milk and 100% juice options in kids meals.

"Boy Eating Burger photo from Shutterstock"

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