Assessing the Availability of Healthier Children's Meals at Leading Quick-Service and Full-Service Restaurants

Objective To compare the calorie, fat, saturated fat, and sodium content of available children's meal combinations in leading restaurants with national recommendations. Design Cross-sectional. Setting Children's menu offerings and corresponding nutrition information were collected (May, 2014) from Web sites of the top 10 quick-service (QSR) and top 10 full-service (FSR) restaurant chains that offered a children's menu and provided nutrition information. Variables Measured Total calories (kcal), percent calories from fat and saturated fat, and total sodium (mg) were calculated for children's meal combinations (QSR N = 1,363; FSR N = 6,654). Combinations with ≤ 600 kcal, ≤ 35% kcal from fat, ≤ 10% kcal from saturated fat, ≤ 770 mg sodium, and those that met all 4 of these criteria were identified. Analysis Frequencies by restaurant segment. Results The majority of QSR (72%) and FSR (63%) meal combinations had ≤ 600 kcal. Only 31.9% of combinations at QSRs and 21.7% at FSRs met all 4 criteria. In both segments the calorie target was most frequently met, and the sodium target the least. Conclusions and Implications Children's meal combinations with ≤ 600 kcal are available at leading restaurant chains, but many meals fail to meet current national recommendations for fat, saturated fat, and sodium. Menu labeling legislation may address caloric content but implications for other nutrients remain unclear.