The best fast food for kids?

With all the pressure on the restaurant industry to improve the nutritional value of kids’ meals, some progress has been made over the past few years. Well, sort of.

A new analysis from the Yale Rudd Center for Food Policy & Obesity found that fewer than 1 percent of all kids’ meals—33 out of 5,427—met the recommended nutrition standards set by the Institute of Medicine. (Only 3 percent met the standards set by the food industry itself.)

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That hasn’t changed since the Yale Rudd Center did its last evaluation in 2010.

But the nutritional quality of specific items offered in kids’ meals has improved. Most fast-food chains now offer at least one healthy side dish in their kids’ meals, and three-quarters have increased healthy beverage options such as unsweetened teas, water, and milk.

“To be honest, it was pretty disappointing,” said Jennifer Harris, director of marketing initiatives at the Yale Rudd Center, who presented the new analysis on Tuesday at the American Public Health Association meeting in Boston. “Most of the main dishes in kids’ meals still have a lot of fat and sodium, so they’re not healthy choices at all.”

That’s not so surprising, but here’s something that was: Two-thirds of kids ordering McDonald’s Happy Meals now get apple slices and a half-size serving of fries instead of a full serving of fries. Before McDonald’s made this the default option in 2011, two-thirds of kids skipped the apple slices and got a full serving of fries.

“People are creatures of habit, and they’ll just continue ordering what they always have unless someone gives it to them automatically,” Harris said.

Walt Disney World theme parks also changed their default side dishes for kids’ meals a few years ago, automatically providing carrots and milk, and only replacing them with a soda and fries if parents specifically asked for them. About 60 percent of parents go with the healthier meals. They recently began offering nutritious kids meals designated with a “Mickey Check” label on the restaurant menu.

Subway offers a yogurt and apple slices instead of chips or cookies with their kids’ sandwhiches unless parents make a request for the unhealthier options.

As far as which kids’ meal combinations are “best” to order from fast-food chains, the Yale Rudd Center provides a list on its website. I’m inclined, though, to call them the “least worst” options since, beyond the healthy side dishes, the main meals are highly processed and contain little fiber and nutrients.

One of the top “best kids’ meal combinations” is Arby’s offering of Kraft Macaroni and Cheese. Burger King’s best meal is chicken nuggets with sweet and sour sauce.

The National Restaurant Association, which represents restaurant owners, maintains that it’s committed to “providing an array of nutritious offerings for children,” said Joy Dubost, director of nutrition in an emailed statement. Its two-year-old Kids LiveWell program promotes meals that meet government nutrition standards, she added, and “the industry has also led the way in advocating that nutrition information be made available to consumers in chain restaurants through a national menu labeling standard.”

The food industry has made some strides when it comes to removing ads for fast-food targeted to young kids, according to the Yale Rudd Center study. Children ages 6 to 11 saw 10 percent fewer ads on their favorite children’s shows and half as many ads on websites than they were seeing three years ago.

That’s the good news.

The bad news is teens still see the same number of ads and were more likely than adults to see television ads for Taco Bell, Sonic, and Starbucks. Teen visitors to Subway.com, Starbucks.com, and McDonalds.com increased by 75 percent or more since 2010.

“The industry says they’re improving advertising to children,” Harris said, “but they’re only taking them off specific children’s TV shows like those shown on Cartoon Network; we know that kids are watching other programs, especially as they get older.”