San Francisco this week became the first major city to pass a so-called Happy Meal ban, on the heels of Santa Clara County establishing its own prohibition of high-calorie, high-fat meals served up with a toy.
But will the battle to reform the meals, aimed at children, spread more widely?
"It's only going to pick up steam," said Ken Yeager, the Santa Clara County supervisor who introduced the ban, which forbids restaurants from giving away toys with meals that don't meet nutritional standards. "The fast-food chains must realize that the tide has turned."
The Happy Meal, which is the focus of the movement, was introduced by fast-food giant McDonald's Corp. in 1979. But several other fast-food chains offer kid's meals with toys.
Yeager said he had received inquiries from officials in New York, Chicago and Orange County, and some public health advocates say the measure is ripe to spread across the country.
"It absolutely wouldn't surprise me," said political consultant Lisa Gritzner with the Los Angeles public relations firm Cerrell Associates. The almost certain backlash from the blogosphere and conservative media outlets, she said, would not necessarily be damaging to a politician whose base was demanding better access to healthy foods.
"These types of issues get a lot of attention," she said. "They raise a lot of interest. They are sensationalistic but not necessarily in a bad way for someone who is trying to make a point."
No major city has mounted an effort as bold as San Francisco's, which was approved by its board of supervisors this week. Even in the Bay Area, known for its progressive tilt, the Happy Meals ban was considered by some officials a fringe issue.
"The day after it was passed it was being mocked around the world," said Tony Winnicker, a San Francisco political strategist and spokesman for Mayor Gavin Newsom, who opposed the ban.
"If you were looking for something to portray a legislative body wasting time and effort at the expense of serious issues, you might invent this issue," he said.
A spokeswoman for McDonald's said the company had not decided how to respond to the San Francisco and Santa Clara County bans.
"It would be premature to comment or speculate further on this matter, at this time," Ashlee Yingling said.
The California Restaurant Assn. has been upfront about the issue, taking out full-page ads in newspapers and lobbying hard against both measures.
Daniel Conway, the organization's lobbyist, said he could see cities like New York, Seattle and Portland, Ore., which have been aggressive in implementing controls on restaurants, considering such a ban. But the measure might attract stiff opposition, he said, along with some ridicule.
"If I was working for a politician I'd be really cautious about embracing this," Conway said. Even in San Francisco, he and others said, supervisors had to put off the vote until election day — after most of the politicking was done — in order to get enough support to override a threatened mayoral veto.
Introducing such a ban could be particularly complicated in Southern California, where it would likely face major geographic, political and demographic challenges, according to local politicians and other policymakers.
"San Francisco is only 49 square miles and only 16% of the households have children," said L.A. Councilman Tom LaBonge, who said he welcomed a discussion on the topic but was hesitant to push for a ban.
Southern California counties are much larger and generally have numerous cities, making it difficult to implement a wide-ranging policy of this type.
For example, Los Angeles County encompasses more than 4,000 square miles and includes 88 cities. Also, more than 34% of households in the county have children.
Public Health Law & Policy, a little-known nonprofit group based in Oakland, came up with the toy-ban strategy while using a state grant to develop ideas to combat childhood obesity.
Samantha Graff, who directs the group's legal analysis team, described Public Health Law & Policy as a think tank made up of lawyers and urban planners who work to develop community policies that encourage healthy eating and exercise — and will stand up in court. She said the group did not lobby and had no formal plans to export the proposal to other places.
But she said that, after the ban's passage in San Francisco and Santa Clara County, calls came in from several municipalities. Graff declined to name them, saying that officials had asked their locales be kept private for now.
Some private organizations have gone public. The Boston-based advocacy group Corporate Accountability International, which is pushing to get McDonald's to quit using the character of Ronald McDonald to market to children, provided advice and public relations support to officials in San Francisco who supported the Happy Meals ban.
Judy Grant, who heads the Boston group's anti-obesity efforts, said politicians in other areas were cautious not only because it's a hot-button issue, but also because it means taking on large corporations such as McDonald's.
But she, too, said she had been contacted by healthy-food activists and others who want to try.
"We heard from people across the country who are excited about this," Grant said. "This is not going to stop at San Francisco."