Illustration of a child looking over a menu

Popular restaurants have been cutting calories in children’s meals and offering some healthier side dishes, according to a study that appears in the April issue of the Journal of Nutrition Education and Behavior.

But fat and sodium levels are still way too high.

Researchers looked at online nutrition information for children’s meal options in 2014 at the 10 most popular fast-food outlets: Arby’s, Burger King, Chik-Fil-A, Dairy Queen, Jack-in-the-Box, KFC, McDonald’s, Sonic, Subway and Wendy’s.

The study also included the 10 most popular sit-down restaurant chains: Applebee’s, Buffalo Wild Wings, Chili’s, Denny’s, IHOP, Olive Garden, Outback Steakhouse, Red Lobster, Red Robin and TGI Friday’s.

Researchers focused on the numerous combinations that children could create from the options for their meals at each restaurant. According to the results, 72 percent of fast-food meals and 63 percent of sit-down meals had 600 calories or less, meaning they met recommended calorie guidelines.

The researchers believe these options offer fewer calories than in the past, in addition to the presence of fruit and veggies as sides in children’s meals. Today, if you buy a kid’s meal at your favorite fast food outlet, you might find something in it you’d never expect: a piece of unadorned, unprocessed fruit.

Unfortunately, researchers found you’d still also find a lot of fat, saturated fat and sodium. The meals still fail to meet recommendations in these areas.

“Improving the availability of healthier kids’ meals is a critical step toward increasing children’s exposure to healthier foods, but that alone is not enough,” said lead author Sarah Sliwa, Ph.D., an instructor at Tufts University Friedman School of Nutrition. “We encourage restaurants to look holistically at the nutritional value of their children’s meals, and to market healthier options in ways that emphasize taste and appeal to parents and children alike.”

As an example, McDonald’s started changing up its sides to counter criticism about its mostly unhealthy menu and to increase sales. Apple Dippers have long come with children’s meals, but the fast food giant also added Cuties brand mandarin oranges in December of 2014. (Researchers considered online menus from May of that year for their study.)

The small Cutie orange contains about 40 calories, only a trace of fat, a few grams of fiber and more than 100 percent of the recommended daily amount of vitamin C. That’s a far more healthy offering than the kid-sized serving of fries that contains about 110 calories, about half of those from saturated fat and little else to offer nutritionally.

McDonald’s  entry into any food area can cause a seismic shift due to the fast food giants’ size. The company’s  buying power dwarfs that of any other restaurant chain – and that impacts the beef, poultry and potato producing industries in the U.S.

A single change in McDonald’s menu can send farmers and producers scrambling to meet demand. When the company adopted Apple Dippers nearly 12 years ago, the fast food chain became the largest restaurant or food service purchaser of fresh apples virtually overnight, and it has served more than a billion bags of apples just since 2012.

That sort of impact means companies plan ahead when adding in healthier options.

“They recognize the role they play and that it can disrupt the market,” said Daniel Sumner, the Frank H. Buck, Jr., Distinguished Professor of Agricultural and Resource Economics at the University of California, Davis.

That planning is motivated by its business interests — McDonald’s doesn’t commit to a new menu item without assurances that a steady supply will be available. And that’s especially important with crops like citrus.

“If a restaurant chain adds a new kind of kale or cauliflower, for example, farmers can expand to meet the demand rapidly,” Sumner said. “But citrus trees require five years to mature and produce fruit.”

A 2005 New York Times story reported that citrus growers were eyeing McDonalds as a possible customer at the time when Apple Dippers were added – so the addition of Cuties, ten years later, came as no surprise. The collaboration between McDonald’s and the producers of Cuties was three years in the making.

Christina Economos, Ph.D., vice chair and director of ChildObesity180, and senior author on the study, said that restaurants can make the changes necessary to make healthy, appealing options more prevalent and prominent.

“We need to combine more nutritious children’s meal offerings with stronger education to drive both supply and demand to support healthier choices,” she said.