Kids’ menus may serve up smaller portions, but smaller doesn’t always mean healthier.
A piece of legislation recently heard in both chambers of the Rhode Island General Assembly would set nutritional standards for restaurants that serve kids’ meals by capping calories, sodium, added sugars, and fats. The default drink included with a children’s meal would be water, milk or a milk substitute.
Sen. Pam Lauria, the bill’s sponsor and a Barrington Democrat, told her colleagues at an April 10 hearing of the Senate Committee on Health and Human Services that the Healthy Kids Act isn’t meant to limit what businesses can do but instead aims to improve families’ access to more nutritious meals for their kids.
“Parents are very busy,” Lauria said. “There are sports, there are activities, and frequently they need to feed their children on the fly, and they will frequent a restaurant to help them to do that.”
The bill would give parents more “healthy options,” Lauria said, by specifying each restaurant with a kids’ menu serves at least two qualifying meals. A healthy kid’s meal per the bill’s definition has no more than 550 calories, 700 milligrams of sodium, and 15 grams of added sugars. A maximum of 10% of calories would come from saturated fat, and no trans fats would be allowed. Portions would need to include at least two of five food groups, with one of them being a fruit or non-fried vegetable.
The remaining kids’ meals would not need to follow these standards, and the default beverage choices could also be swapped out at the customer’s request.
“What this bill does not do is stop restaurants from serving anything else that they want for children,” Lauria said to the Senate committee. “Kids can still have a hot dog if it’s on the menu, kids can still have chicken nuggets if they’re on the menu. Kids can still have a soda if they prefer if their parents allow. This (bill) just says that we have to acknowledge that we need healthy options available and that the healthy options should probably be default, particularly when it comes to sugary drinks.”
On the House side, the Healthy Kids Act is sponsored by Rep. Susan Donovan, a Bristol Democrat, and has not yet been scheduled for a committee hearing.
Lauria said that the bill was spurred by the “heartbreaking” prevalence of obesity among Rhode Island kids. According to the 2024 Rhode Island KIDS COUNT Factbook, Rhode Island ranks last place in New England for the number of children ages 10 to 17 that are overweight or obese, accounting for 35% of that demographic. Rhode Island ranks 39th on this same metric nationally, according to the factbook. There are also racial disparities in these numbers, the factbook noted: In 2022, 17% of Hispanic children ages 2 to 17 were overweight and 32% were obese, and 16% of non-Hispanic Black children were overweight and 28% were obese.
Doctors showed up to support the bill last week in the Senate, including Dr. Amy Nunn, CEO of the Rhode Island Public Health Institute and a professor at Brown University.
The proposal is “just a common sense bill that promotes healthy opportunities for kids,” Nunn said. “Our obesity rates are nearly on par with states in the Deep South…Our children, our Hispanic children in Rhode Island, fare 49th in terms of lifetime health and education achievements. Those statistics are breathtaking.”
Nunn said the bill was about making accessible the kinds of meals “you would want to put in front of your children. Nobody wants their kids to be eating supersized food.”
Dr. Philip Chan, also of the Public Health Institute and a primary care physician with Brown University Health, framed the bill as a preemptive measure to reduce chronic disease rates and health problems seen in Rhode Island’s adult population.
“These behaviors start in childhood, right? So we have to start there in terms of addressing them,” Chan told senators. “You can have the chicken nuggets, you can have the lemonade or soda every once in a while, but have a vegetable, have a fruit. This is the thing that we try to teach our children. A lot of times you can’t find veggies or fruit on the menu. You have to order it specially made.”
Hamburger Happy Meal qualifies
The push to legislate healthier kids’ menus is not new. An April 2024 roundup by the Center for Science in the Public Interest found over 30 jurisdictions have laws governing children’s meals. The majority of these laws regulate the default beverage to push kids away from soda or other sugary drinks. Nutrition-based laws — ones closer to Rhode Island’s current proposal — are largely found in county-level governments, many of them in Maryland. Statewide initiatives in California, Hawaii, Delaware and Illinois have focused on beverages.
Before the Senate committee, Nunn referenced these efforts, saying, “The data and studies around these bills show that they have had demonstrable impacts on improving healthy eating behaviors among kids and among people of color. So the science around all of this is really sound, and it really hasn’t had a huge detrimental impact on restaurants.”
You can have the chicken nuggets, you can have the lemonade or soda every once in a while, but have a vegetable, have a fruit.
Industry giants like McDonald’s have had enough time to change and accommodate the trend. The fast food juggernaut at first took a subversive approach to regulations, like in 2011 when McDonald’s locations in San Francisco started selling Happy Meal toys for 10 cents to get around a municipal law banning toys’ inclusion with unhealthy meals. But by 2014, McDonald’s had started to retool its menu, and in 2018 announced all of its kids’ meals would max out at 600 calories by 2022.
Today, a hamburger Happy Meal would satisfy the requirements of Rhode Island’s Healthy Kids Act. The cheeseburger Happy Meal, however, would not, as it exceeds pretty much every threshold specified in the bill (as well as McDonald’s previously stated goal, as it has 690 calories).
As for the enforceability of the proposed law, the Rhode Island Department of Health (RIDOH) would be charged with ensuring compliance. The bill text prescribes the health department to issue relevant rules and regulations, supply multilingual signage and outreach materials for restaurants, and check that restaurants are training staff properly and maintaining documentation about their meals’ compliance.
But Dr. Jerome “Jerry” Larkin, the health department’s director, wrote in a testimony that those duties are easier said than done.
The department “applauds the intent of the proposed legislation, which is to establish and enforce environmental food changes to address rising childhood obesity and associated chronic disease emergence in Rhode Island,” Larkin wrote. “However, RIDOH would not be able to implement the provisions outlined in the bill without adequate resources.”
The department would need another full-time position to enforce the bill, Larkin wrote — specifically, a “grade 27” full-time, nutritionist position that would cost $116,544 a year, with that salary expected to increase in future years.
Rolling out content like signage, plus tracking and analyzing compliance, would cost about $1,850 in the first year, Larkin wrote. The proposed cost for an extra nutritionist comes at a time when the department is still reconciling the recent loss of $31 million in federal grant money, as well as the potential loss of dozens of existing full-time staff.
The Senate committee voted to hold Lauria’s bill for further study, the typical procedure for a bill at its first hearing.
This story was originally published by the Rhode Island Current.
