The Five Worst “Healthy” Fast-Food Kids Meals

The Physicians Committee

The Five Worst “Healthy” Fast-Food Kids Meals

A Report by the Physicians Committee for Responsible Medicine
June 2012

Last year, top fast-food chains including McDonald’s and Burger King announced plans to make kids meals healthier. Nearly a year after those announcements, nutrition experts with the Physicians Committee for Responsible Medicine (PCRM) evaluated kids meals from these and other fast-food restaurants and found that many are still loaded with fat, cholesterol, and sodium. These “healthy” meals put children at risk for obesity, diabetes, cancer, and other diet-related diseases.

Passing off unhealthful foods as “healthy” is especially troubling at a time when 16.9 million American children and adolescents are obese. A recent study in the journal Pediatrics found that nearly one-quarter of U.S. adolescents have diabetes or prediabetes.


PCRM dietitians found that most so-called “healthful” kids meals are still alarmingly high in fat, cholesterol, and sodium. Here are the five worst “healthy” fast-food kids meals:

Five Worst “Healthy” Fast-Food Kids Meals
Meal Nutrition Shocker
Chick-fil-A Kids Grilled Nuggets Kids Meal Contains the same amount of cholesterol as a Big Mac.
McDonald’s Cheeseburger Happy Meal Contains more sodium than 13 orders of McDonald’s kids fries.
Sonic Kids’ Jr. Burger Meal Contains more sugar than two Twinkies.
Burger King Hamburger Kids Meal Contains almost as much cholesterol as six slices of pork bacon.
Denny's Build Your Own Jr. Grand Slam Contains almost 100 more milligrams of sodium than the government recommends children consume at breakfast.


An apple a day doesn’t always keep the doctor away. Not when it’s part of an otherwise unhealthful kids meal. Restaurants are increasingly marketing “healthy” versions of kids meals, but often these meals feature the same unhealthy entrées paired with healthier sides, like apple slices instead of french fries. Along with those apple slices, kids are still getting cholesterol-laden chicken, artery-clogging cheeseburgers, and cancer-promoting processed meats. Reduced-fat and fat-free plain or chocolate milk is often offered as a “healthier” beverage option, but it still contributes to a meal’s overall cholesterol and sugar counts.

Many of the fast-food chains scrutinized in the report are part of Kids LiveWell, a National Restaurant Association program launched last year that is supposed to promote nutritious options for kids at chain restaurants.

Burger King, Chick-fil-A, Denny’s, Sonic, and 49 other restaurant chains with more than 25,000 locations around the country are members of Kids LiveWell. To participate, restaurants need only offer one "healthful" entrée and one "healthful" side dish. Some of the restaurants do offer fruits and vegetables as side dishes. But typical offerings include bacon at Cracker Barrel, sirloin steak at Outback Steak House, and grilled cheese at Au Bon Pain.

McDonald’s does not participate in Kids LiveWell. But last July, the fast-food giant also announced plans to make its Happy Meals more nutritious. This spring, McDonald’s launched commercials to emphasize the “benefits” of eating Happy Meals. But the three Happy Meal entrée choices it offers are inherently high in fat, cholesterol, and sodium: hamburger, cheeseburger, and chicken nuggets. McDonald’s did introduce apple slices and smaller packets of french fries as side dish options in Happy Meals.

Key Factors

PCRM dietitians looked at several key factors to determine the healthfulness of each item:

High Fat Content: Diets high in fat have been linked by scientific research to increased risk of cancers, diabetes, and heart disease. High-fat, low-fiber foods boost the hormones that promote cancer. Specifically, diets high in meat, dairy products, fried foods, and vegetable oils cause an increase in the production of estrogen. Extra estrogen increases cancer risk in the breast and other organs sensitive to sex hormones. In January 2010, the Centers for Disease Control and prevention found that 20 percent of adolescents ages 12 to 19 have at least one abnormal lipid level (LDL cholesterol, HDL cholesterol, or triglycerides). Among overweight and obese adolescents, those rates were higher, with 22 percent of overweight and 43 percent of obese children having one or more abnormality. Trans fats raise LDL (“bad”) cholesterol levels and lower HDL (“good”) cholesterol levels, increasing the risk of cardiovascular disease. Naturally occurring trans fats are only contained in animal products. Fat contains 9 calories per gram and is typically more abundant in animal products, especially saturated fat, which significantly increases bad cholesterol.

Sodium: Diets high in sodium can increase the risk of high blood pressure, a condition that can lead to cardiovascular disease and kidney problems. The Institute of Medicine (IOM) recommends that children’s intake of sodium should be less than 640 to 740 milligrams (depending on age) at lunch and less than 430 to 500 milligrams (depending on age) at breakfast. Some health experts suggest consuming less than 1,500 milligrams of sodium per day.

Cholesterol: Cholesterol is a waxy substance found in the bloodstream and in the body's cells. Every animal cell contains cholesterol as it is a necessary component of the cell’s membrane. The body naturally makes more than enough cholesterol to serve this biological function. High blood-cholesterol levels are strongly linked to risk of heart disease. High levels of LDL (“bad”) cholesterol and low levels of HDL (“good”) cholesterol increase the risk of heart disease and stroke. Saturated fats and trans fats both increase LDL levels. Consuming large amounts of cholesterol in one’s diet may eventually lead to reduced heart function. Fiber helps to remove blood cholesterol and is only found in plant foods.

Red and Processed Meats: Consuming processed meats increases the risk of colorectal cancer, according to a large number of studies, including the European Prospective Investigation into Cancer and Nutrition (EPIC) study. A new study from the Harvard School of Public Health says that a daily serving of processed meats, like hot dogs, sausages, and bacon, increases the risk of premature death by 20 percent. Each daily serving of red meat increased the risk of dying by 12 percent.

Detailed Results

PCRM dietitians obtained nutrient information by reviewing the company websites. Dietitians evaluated each item based on data including the item’s calories, total fat, saturated fat, cholesterol, sodium, and sugar.

Chick-fil-A Kids Grilled Nuggets Kids Meal
Six grilled nuggets, waffle potato fries, and low-fat chocolate milk
570 calories, 19 grams of fat, 4 grams of saturated fat, 75 milligrams of cholesterol, 1,150 milligrams of sodium, 23 grams of sugars

Earlier this year, Chick-fil-A added grilled chicken nuggets to its kids meals menu, touting them as a “healthier” alternative to fried chicken nuggets. But the grilled chicken nuggets alone contribute 840 milligrams of sodium. And combined with low-fat chocolate milk and waffle potato fries, this meal is also loaded with fat and cholesterol. Grilled chicken is the largest source of PhIP, a potent carcinogen that may play a role in the development of breast, prostate, and other cancers. Because of the high cholesterol levels in meals like this, the American Academy of Pediatrics has endorsed a recommendation that all children have a cholesterol screening performed between the ages of 9 and 11.

McDonald’s Cheeseburger Happy Meal
Cheeseburger, fries, apple slices, and low-fat white milk
520 calories, 20 grams of fat, 8 grams of saturated fat, 50 milligrams of cholesterol, 920 milligrams of sodium, 22 grams of sugars
McDonald’s announced last year that it would make its kids meals more healthful. But McDonald’s Cheeseburger Happy Meal won’t make anybody’s heart happy. The cheeseburger is loaded with unhealthful fat and cholesterol, which contribute to childhood obesity. And the meal has more sodium than a child should eat in a meal, according to guidelines from the IOM.

Sonic Kids’ Jr. Burger Meal
Jr. Burger, apple slices with fat-free caramel dipping sauce, and apple juice
550 calories, 17 grams of fat, 6 grams of saturated fat, 35 milligrams of cholesterol, 715 milligrams of sodium, 42 grams of sugars
This meal contains more sugar than two Twinkies. The caramel dipping sauce may be fat-free, but it’s loaded with sugar. The consumption of added sugars, which are sweeteners added to processed and prepared foods, has been associated with measures of cardiovascular disease risk among adolescents, including adverse cholesterol concentrations, according to a new report from the CDC.

Burger King’s Hamburger Kids Meal
Hamburger, fat-free milk, and apple slices
380 calories, 10 grams of fat, 4 grams of saturated fat, 40 milligrams of cholesterol, 615 milligrams of sodium, 24 grams of sugars
This meal features a cholesterol-laden hamburger as the entrée. Adding apple slices to the meal helped Burger King qualify for the Kids LiveWell program, but the meal contains 40 milligrams of cholesterol—almost as much as six slices of pork bacon.

Denny's Build Your Own Jr. Grand Slam
Egg whites, two slices of turkey bacon, hash browns, and orange juice
332 calories, 11 grams of fat, 4 grams of saturated fat, 40 milligrams of cholesterol, 570 milligrams of sodium, 30 grams of sugars
This breakfast contains almost 100 more milligrams of sodium than the IOM recommends children should consume at breakfast. The two pieces of turkey bacon in this meal are processed meat. Consuming processed meats increases the risk of type 2 diabetes, according a 2011 study in the American Journal of Clinical Nutrition.