Fried chicken fingers and nuggets, fries and soda are the most common items offered to children, and some kids meals contain more than 1,000 calories and are high in sodium and fat, according to the Center for Science in the Public Interest (CSPI). The government's dietary guidelines recommend that children ages 4 to 10 eat 1,200-2,200 calories for the entire day.
"This is really disappointing," says Margo Wootan, director of nutrition policy for CSPI. "Restaurants should be doing better."
The findings come after many restaurants have made some strides in offering healthier fare on kids' menus, including serving more fruit, vegetables and fat-free and low-fat milk.
CSPI worked with a nutrition researcher at the University of North Carolina at Asheville to analyze 3,498 kids' meal combinations from 41 top chain restaurants; 34 chains provided nutrition information for those meals.
The findings show:
-- 91% of kids' meals at those chains do not meet the National Restaurant Association's Kids LiveWell menu standards, a voluntary initiative. It recommends healthy kids' meals have 600 calories or less, get 35% or less of their calories from total fat and total sugar, have no more than 770mg sodium and also meet other nutrition criteria. The standards emphasize lean protein, fruits, vegetables, whole-grain and low-fat dairy products.
-- Nine of the top chain restaurants, including McDonald's, do not have a single kids' meal that meets the Kids LiveWell standards.
-- 50% of the kids' meals had more than 600 calories.
-- 78% of the chains offer soft drinks as a children's beverage option; 58% offer fruit juices; 40% offer fat-free or 1% low-fat milk; 43% offer high-fat milk (2% or whole).
-- 83% serve fried chicken entrees for kids' meals, such as chicken fingers or nuggets; 35% serve grilled chicken; 65%, hamburgers.
-- 73% of kids' menus offer fried potatoes such as French fries and potato chips; 53% offer veggies other than fried potatoes with children's meals; 68% offer fruit. The most common choices: apple slices, applesauce, fruit cups, mandarin oranges and grapes.
There has not been much improvement since the consumer group did a similar study in 2008, Wootan says.
Still, some restaurants are making strides. For instance, all of Subway's children's meals, which include apple slices and water, apple juice or 1% low-fat milk, meet nutrition standards for calories, sodium and fat, Wootan says.
Joy Dubost, director of nutrition for the National Restaurant Association, says the industry has been rapidly expanding its offering of healthy meals through the Kids LiveWell program. "It launched in 2011 with 19 brands, including both chain restaurants and mom-and-pop operations. We now have 130 brands representing 40,000 restaurant locations," she says.
"We're providing healthful items on the menu, and we encourage parents and the child to order the options that fit into an overall healthy diet."
Anita Jones-Mueller, founder of the company Healthy Dining (healthydiningfinder.com), which works with the restaurant association on the Kids LiveWell program, says, "As a parent, it's sometimes hard to get kids to eat healthy, but Kids LiveWell options make it easier.
"It's exciting to see so many restaurants creating healthier choices because it helps parents feel good about eating out, knowing that their children have nutritious options," she says.
Wootan says children are getting about 25% of their daily calories from fast-food places and other restaurants, and consumption of restaurant food is associated with higher calorie intake and poorer diet quality.
"Restaurant children's meals are one of the reasons that kids think their food should be chicken nuggets, pizza and hamburgers with a side of fries and a soda," she says. "It defines what they think of as kids' food, and most of these meals are the opposite of what they should be learning to eat. These meals set them up for a lifetime of unhealthy eating.
"We need to get to the point that kids' meals are the most nutritious foods on the menu, because kids are growing and developing and forming eating habits that are going to affect their health and weight for the rest of their lives," she says.
Currently, about a third of children and teens are overweight or obese, which puts kids at greater risk of developing a host of debilitating and costly diseases, including type 2 diabetes, high blood pressure and high cholesterol.
Worst Kids' Meals: The CSPI names these as some of the worst kids' meals in terms of calories and other nutrients:
-- Applebee's grilled cheese on sourdough bread, fries, and 2% chocolate milk, 1,210 calories.
-- Chili's pepperoni pizza with homestyle fries and soda, 1,010 calories.
-- Denny's Jr. cheeseburger and french fries (beverages are not included with kids' meals), 980 calories.
-- Ruby Tuesday's mac 'n cheese, white cheddar mashed potatoes and fruit punch, 860 calories.
-- Dairy Queen's chicken strips, kids' fries, sauce, Arctic Rush (a frozen drink), and Dilly Bar, 1,030 calories.