What’s stopping restaurants from offering healthier kids’ meals?

By Dr. Liji Thomas, MDMay 13 2025

Even when restaurants want to serve healthier food to kids, hurdles like picky eaters, food waste, and profit margins can get in the way. This study reveals the tensions and the opportunities for healthier family dining.

Study: Restaurants Offering Healthier Kids’ Menus: A Mixed-Methods Study. Image Credit: Irina WS / Shutterstock

Children are more likely to develop healthy food habits if they have a good food environment. Restaurants, however, typically provide unhealthy kids’ menus. A recent study in the journal Nutrients examined the various factors that drive the development of kids’ menus in restaurants in the Netherlands and the opportunities to offer healthier choices.

Introduction

Cheap, energy-dense, unhealthy foods and drinks abound in Western society, promoting childhood obesity. This puts millions at risk for cardiovascular disease, type 2 diabetes, cancer, and osteoarthritis, among others.

Eating out is an important food environment. Restaurants offer larger portion sizes of richer and less healthy food. Kids’ meals are typically meat-based, high in calories, salt, and saturated fat. This means that restaurants often miss the opportunity to make healthy food options more attractive and visible, so that children can learn to choose them.

The current study used mixed methods to gather information from various stakeholders. Restaurant owners, managers, and chefs completed a questionnaire online, and some were then interviewed in a semi-structured manner.

The research was conducted in Nijmegen, the Netherlands, as part of a local initiative involving academic institutions, municipal health services, and local restaurants. The initiative aimed to co-create healthier kids’ meals with input from primary school children and chefs.

Study findings

The findings reveal that most participants were aware of the need for healthy menu choices for kids and were willing to offer them. The survey also found that only some restaurants had fully healthy kids’ menus, while the majority offered “partially healthy” ones. Some chefs reported trying to balance healthy ingredients with taste, though this was reported anecdotally and was not directly measured in the study.

However, 87.5% of participants cited the perceived low demand from children for healthy kids’ meals when eating out, while 76.2% reported low parental demand. Many participants saw eating out as a treat or special occasion, which influenced parents to choose less healthy options for their children. Children tended to ignore fruit and vegetables in their meals, leading to them not being offered.

Restaurants with no kids’ menus found the idea of shifting to healthier options easiest, while those with unhealthy menus perceived it as most difficult. Restaurants with partially healthy kids’ menus fell in between. Restaurants with healthy kids’ menus offered creative options and varied flavors.

Many restaurants base their kids’ menu on the adult menu. Over half of restaurants (57.6%) reported this practice. A fifth of all restaurants expressed the need for innovative healthy recipes for kids.

Therefore, participants felt that proof that children and their parents really want healthy options is needed. This may help motivate restaurants in this direction.

Motivations

Restaurants were eager to improve their image, promote healthy original dishes for kids’ menus, and shape family lifestyles and children’s overall health. Restaurants without kids’ menus were most motivated. All groups were equally aware of and willing to make changes towards healthier options for children.

Participants wanted to offer nutritious and delicious food to please and engage children. Some also said that children’s foods should promote health, and parents should be aware of such options.

Other motivations included keeping up with food trends, creating a connection with guests, and anticipating changes in family eating habits. The study also highlighted that social responsibility, public health, and ethical considerations, as described by the Corporate Social Responsibility Model (CSRM), may influence menu decisions alongside profit concerns.

Hindrances

Participants feared wasting food by offering choices less popular among children, including vegetables and fruits. These are highly perishable and, if not used, would eat into the restaurant's profits. Offering children the same foods as adults but in smaller portions could mitigate this problem, besides presenting healthy eating as “natural and normative.”

Individual interviews suggested that more effort would go into stocking, preparing, and using fresh rather than frozen ingredients, which would involve more potential waste, shorter shelf life, less convenience, and higher costs. Even frozen ingredients were often wasted since children left behind significant amounts of food, underlining how difficult it is for children to calculate proper portion sizes.

Some participants said they lacked space for kids’ menus or cited a lack of demand for healthy kids’ meals. Most said that children prefer fries, snacks, and such unhealthy foods, making healthy kids’ meals unprofitable.

When eating out, parents often justify ordering unhealthy favorites for their children by thinking of it as giving them a treat. They enjoy the convenience and do not have to struggle against the child’s preferences.

Operational barriers, such as lack of time, limited kitchen space, insufficient staff knowledge, and the perceived complexity of menu changes, were also reported.

Positive perceptions

Some participants saw improving the kids’ menu as a healthy initiative, broadening children’s palates by creating appealing versions of healthy foods. Avoiding sugary drinks and not adding salt or sugar, flavor enhancers, and other additives while preparing kids’ meals already means healthier food.

More vegetarian and organic options are coming up in restaurants. Many restaurants attract families with young children, which can promote a demand for healthier kids’ menus, mainly when located in a green environment.

Diehard healthy eaters were likelier to order the same food for their children.

In neighborhoods with more young families and health-conscious clientele, there was greater interest in healthier options for kids.

Potential solutions

Moving forward, it would involve creating more creative kids’ meals, basing them on adult options, and incorporating the strong preferences shown by children into healthier choices. One restaurant manager quipped, “We want to be right in the sweet spot, so that it’s indulgent and healthy at the same time. And finding that sweet spot is the big challenge of a healthier kids’ menu.”

Another said that children’s meals were not on the menu but were suggested while taking orders if the parents asked about them. Participatory strategies included obtaining suggestions from children, parents, and chefs for healthy meals.

Another option was to include healthy and unhealthy foods on the menu to ensure everyone got what they wanted. Such participatory approaches and financial incentives may promote business while reducing turnover and profit losses.

The study also suggests that creative presentation, appealing names and stories, and collaboration with local health initiatives can help increase acceptance of healthier kids’ meals. Offering smaller portions of adult meals to children was seen as both efficient and effective in exposing children to a wider variety of healthy foods while reducing food waste.

The authors note that external incentives, such as subsidies, tax incentives, and community support, may be needed to offset the perceived financial risks and encourage the restaurant sector to make these changes.

Conclusions

This study leads the way in examining the attitudes and motivations of restaurant owners, managers, and chefs toward making kids’ menus healthier in Dutch restaurants. While willingness and motivation are certainly present, hindrances include food waste, lack of demand by children for healthy food when eating out, increased time and effort by restaurant staff, and reduced profits.

These agree with the Retail Food Environment and Customer Interaction Model (RECIM) findings, promoting consumer interactions and factors in business practices while deciding on products. The study highlights the importance of both consumer demand and business operations in shaping menu offerings. Further research should explore whether and how children and parents want healthier foods when eating out, which could facilitate such a transition.

The authors also caution that their findings are based on a relatively small sample, collected during a period of COVID-19-related disruptions, which may affect generalizability. Nonetheless, their insights provide important starting points for future interventions and research.