Fast food giants are happy to promote healthy menus - they are in the revenue generation business, they will sell what people want to buy.

Yet food activists and government officials seem to lack basic insight into what kids want, whereas marketing will make whatever campaigns companies want - even if they know they won't work. But they are trying to make healthier food sound appealing, thus coming up with names like Fresh Apple Fries.

Even kids ages 3 to 7 have little interest in attempts at depicting healthier kids' meals, according to a new study by Dartmouth-Hitchcock Norris Cotton Cancer Center in JAMA Pediatrics.  Or they are just confused at efforts to make apples equivalent to the food kids want when they go out.

A third of children did not identify milk when shown McDonald's and Burger King children's advertising images depicting that product. Sliced apples in Burger King's ads were identified as apples by only 10 percent of young viewers; instead most reported they were french fries. Other children admitted being confused by the depiction.

"Burger King's depiction of apple slices as 'Fresh Apple Fries' was misleading to children in the target age range," said principal investigator James Sargent, MD, co-director Cancer Control Research Program at Norris Cotton Cancer Center. "The advertisement would be deceptive by industry standards, yet their self-regulation bodies took no action to address the misleading depiction."

Deceptive is being used incorrectly here. Yes, companies are trying to fool children - into thinking the same food they get at home is worth ordering when they go out, something virtually no adult does.

In 2010 McDonald's and Burger King began to advertise apples and milk in kids meals. Sargent and colleagues studied fast food television ads aimed at children from July 2010 through June 2011. In this study researchers extracted "freeze frames" of Kids Meals shown in TV ads that appeared on Cartoon Network, Nickelodeon, and other children's cable networks. Of the four healthy food depictions studied, only McDonald's presentation of apple slices was recognized as an apple product by a large majority of the target audience, regardless of age. Researchers found that the other three presentations represented poor communication.

This study follows an earlier investigation conducted by Sargent and his colleagues, which found that McDonald's and Burger King children's advertising emphasized giveaways like toys or box office movie tie-ins to develop children's brand awareness for fast food chains, despite self-imposed guidelines that discourage the practice.

While the Food and Drug Administration and the Federal Trade Commission play important regulatory roles in food labeling and marketing, the Better Business Bureau operates a self-regulatory system for children's advertising. Two different programs offer guidelines to keep children's advertising focused on the food, not toys, and, more specifically, on foods with nutritional value.

"The fast food industry spends somewhere between $100 to 200 million dollars a year on advertising to children, ads that aim to develop brand awareness and preferences in children who can't even read or write, much less think critically about what is being presented." said Sargent.