Table 7.

Comparison of nutrient standards specified by healthy kids’ meal laws (N=3) enacted in the United States from January 2010 through August 2020 to expert and industry nutrition guidelines for meals

Nutrient/Food Group	Guidelines		Nutrient Standards of Healthy Kids’ Meal Laws (N=3)
	NSLPa Meal Standards	NRA’s KLWb Kids’ Meal Standards	Santa Clara Countyc Standards	San Franciscod Standards	Louisvillee Standards
Overview	Lunch meals for kids in grades K-5 must adhere to the guidelines below.	Kids’ meals must adhere to the guidelines below.	The Santa Clara County toy restriction prohibits restaurants in the unincorporated parts of the county from giving away toys and other incentives, such as games, trading cards, admission tickets, or other consumer products (physical or digital), with any foods, beverages, or meals that exceed any of the nutrient criteria below.	The San Francisco toy restriction prohibits restaurants from distributing any free toy, game, trading card, admission ticket, or any other consumer product, whether digital or physical, with kids’ meals or with foods and beverages unless they meet the nutrient requirements below.	The Louisville nutrition requirements and healthy default beverage law mandates that restaurants that provide kids’ meals are required to provide at least one healthy default beverage option and at least one of the menu options listed below.
Calories	550–650 kcals	550 kcals or less	Meals: 485 kcals Single food items: 200 kcals Beverages: 120 kcals	Meals: Less than 600 kcals	--
Sodium	935 mg or less	700 mg or less	Meals: 600 mg Single food items: 480 mg	Meals: Less than 640 mg	--
Total fat	--	--	Meals: 35% of total kcals from fatf Single food items: 35% of total kcals from fat Beverages: 35% of total kcals from fat	Meals: Less than 35% of total kcals from fatf Single food items: Less than 35% of total kcals from fat Beverages: Less than 35% of total kcals from fat	--
Saturated fat	Less than 10% of kcals	10% or less of kcals	Meals: 10% of total kcals from saturated fatf Single food items: 10% of total kcals from saturated fat	Meals: Less than 10% of total kcals from saturated fatsf	--
Trans fat	0% of kcals	0% of kcals	Meals: 0.5 g of trans fat Single food items: 0.5 g of trans fat	Meals: Less than 0.5 g of trans fats	--
Added sugars	--	15 g or less	Meals: 10% of kcals from added caloric sweeteners Single food items: 10% of kcals from added caloric sweeteners Beverages: 10% of kcals from added caloric sweeteners	--	--
Fruits	½ cup	At least ½ cup	--	Meals: ½ cup or more of fruit	Meals: At least ¼ cup of unfried fruit
Vegetables	¾ cup	At least ½ cup	--	Meals: ¾ cup or more of vegetables	Meals: At least ¼ cup of unfried vegetables, excluding white potatoes
Non/low-fat dairy g	--	At least 1 cup	--	--	--
Whole grains	½ of all grains offered must be at least 51% whole grain	½ of all grains offered must be at least 50% whole grain	--	--	A whole grain product that contains not less than 51% by weight in whole grain ingredients, or list whole grain as the first ingredient
Meat/Meat alternates	At least 1 oz (not to exceed 10 oz)	At least 1 oz	--	--	A lean protein, defined as a food containing less than 10 g of fat, 4.5 g or less of saturated fat and less than 95 mg of cholesterol/100 g and per labeled serving
Milk g	1 cup	--	--	--	--
Additives: Caffeine, Sweeteners	--	--	Beverages: No caffeine or added non-nutritive sweeteners	Single food items: Less than 10% of kcals from added caloric sweeteners Beverages: Less than 10% of kcals from added caloric sweeteners	--
Meets NSLP standards Under OVSh, students must select: At least ½ cup of fruits and/or vegetables AND At least 2 of 5 food components: ½ cup serving of fruits ¾ cup serving of vegetable 1-oz serving of meats/meat alternates 1-oz serving of grains 1 cup serving of milk			No, did not meet the standards for food components required because it failed to include any food components.	No, did not meet the standards for certain food components because it failed to include specifications for whole grains and meat/meat alternates, thereby, making it impossible to select at least 3 distinct food components.	No, did not meet the standards for calories, sodium, saturated fat, trans fat, and some food components because it either did not include them or served less than the recommended serving sizes.
Meets NRA’s KLW voluntary criteria			No, did not meet the standards for added sugars and food components because it failed to include them.	No, did not meet the standards for meal calories, added sugars, and certain food components such as non-fat/low-fat dairy, whole grains, and meat/meat alternates.	No, did not meet the standards for calories, sodium, saturated fat, trans fat, added sugars, and some food components because it either did not include them or served less than the recommended serving sizes.

^aUS Department of Agriculture Food and Nutrition Service. Final rule: Nutrition standards in the National School Lunch and School Breakfast programs. 77 Federal Register 4088–4167. 2012. Codifed at 7 CFR §210. Accessed September 1, 2020, https://www.federalregister.gov/documents/2012/01/26/2012-1010/nutrition-standards-in-the-national-school-lunch-and-school-breakfast-programs.

^bNational Restaurant Association’s (NRA) Kids Live Well (KLW) 2019. Accessed September 1, 2020, https://restaurant.org/manage-my-restaurant/food-nutrition/kidslivewell.

^cAn Ordinance of the Board of Supervisors of the County of Santa Clara Adding Chapter XXII of Division A18 to the County of Santa Clara Ordinance Code Relating to Toys and Other Incentives with Restaurant Food. May 11, 2010. Available at https://bit.ly/3BA5lEx. Accessed August 1, 2020.

^dOrdinance Amending Article 8 of the San Francisco Health Code by Adding Sections 471.1 through 471.9, to Set Nutritional Standards for Restaurant Food Sold Accompanied by Toys or Other Youth Focused Incentive Items. November 23, 2010. Available at https://bit.ly/3BvInhH. Accessed August 1, 2020.

^eAn Ordinance Amending Chapter 118 of the Louisville Metro Code of Ordinances Regarding Establishing the Nutrition Requirements and Default Beverages Offered with Children’s Meals (as Amended). June 7, 2018. Available at https://bit.ly/2WHZQ7J. Accessed August 1, 2020.

^fExcept for fat contained in nuts, seeds, peanut butter, or other nut butters, or an individually served or packaged egg or individually served or packaged low-fat or reduced fat cheese.

^gThis was not evaluated as part of the nutrition standards because it has been evaluated using beverage standards - evaluated separately in Table 3.

^hUS Department of Agriculture Food and Nutrition Service. Updated offer vs serve guidance for the NSLP and SBP beginning SY2015–16. Published December 24, 2015. Accessed August 16, 2021, https://www.fns.usda.gov/updated-offer-vs-serve-guidancenslp-and-sbp-beginning-sy2015-16.