McDonalds needs to step up its Happy Meal game, public health officials say.

Once again, Ronald McDonald finds himself in the crosshairs of the public health debate: The red-headed stepchild, err, clown, doesn't always offer alternatives to French fries when taking orders for a child's Happy Meal. And he needs to stop luring kids with those toys he puts in his meals, a group of public health advocates say. Overall, McDonalds is doing too little to help keep kids fit and healthy, and doing to much to start kids on a path of unhealthy habits, according to a new study by the consumer group Center for Science in the Public Interest (CSPI). (See Justmeans writer Nathaniel Payne's piece today for more on the advertising power of toys and public health advocates' thoughts).

This week USA Today reported that public health researchers with CSPI ordered 75 Happy Meals at 44 McDonald's across the United States and found that in 93 percent of cases, servers gave French fries with the meal and didn't ask if the customer wanted the alternative that McDonalds does offer: apples with caramel sauce, called Apple Dippers. When ordering a Happy Meal, customers also can choose a soda, milk or juice, but in a vast majority of cases the servers mentioned soda as the first option, according to the news report.

Even worse than not offering the more benign Apple Dippers, public health researchers noted, some three quarters of all McDonalds stores targeted in the study had toy displays advertising the Happy Meals. Officials with the CSPI have urged the fast food giant not to use toys to lure children to eat unhealthy meals. Furthermore, CSPI wants McDonalds to offer the healthier beverages and sides first before telling customers that they can choose French fries and sodas. The group has said it could sue McDonalds if the company continues to use toys in its marketing. McDonalds has defended its practices, saying it offers customers both high quality foods and toys.

It's an interesting argument, but one the public health advocates with CPSI are unlikely to win. Even if the group were successful in removing the toys from the Happy Meals, its not likely that kids will suddenly lose their taste for the high-fat, high-sodium hamburgers and fries. And there's so much going on outside McDonalds' doors that's contributing to the obesity epidemic among our nation's children. One thing the Center for Science in the Public Interest could do is develop a campaign to get families to cook and eat together. Another study, released earlier this year published in the March issue of Pediatrics magazine, found that four-year-olds who regularly ate dinner with the family, got enough sleep and watched less than two hours of TV a day were 40 percent less likely to be obese than young children who did not.

In any case, we can't approach the issue of public health for children in a vacuum. Removing a single toy from a happy meal won't solve the problem, nor will any one of the strategies above do the trick. It has to be a concerted effort at the forefront of our public conscience. What do you think?

Photo Credit: evelynishere