It wasn't so long ago that kids' menus were almost an afterthought for most restaurateurs, who casually courted the wee folk with the traditional hamburger and fries, mac and cheese, peanut butter and jelly, and, perhaps, spaghetti and tomato sauce.

Increasingly, though, serious concerns about childhood obesity in the United States have prompted chefs and restaurateurs to take a closer look at the nutritional value of their children's offerings and make some long-needed adjustments by emphasizing more fresh fruit and vegetables, grains and lean proteins, like turkey.

“Childhood obesity continues to be an alarming problem for our country,” says Joan McGlockton, the National Restaurant Association's vice president of food policy. “Over a third of the children are obese or overweight … and that could lead to chronic health issues down the road.”

Even U.S. First Lady Michelle Obama has weighed in on the issue when, in 2010, she launched a national campaign called “Let's Move,” which seeks to combat childhood obesity by employing comprehensive strategies and mobilizing public and private sector resources — including the restaurant industry.

To help operators and chefs deal with the issue, the NRA launched the Kids LiveWell program in collaboration with Healthy Dining in 2011. Among other things, participating restaurants agree to feature on their menu at least one full nutritionally focused kids’ meal — entrée, side option and beverage — containing 600 calories or less and requiring at least two sources from fruit, vegetables, whole grains, lean protein and lower-fat dairy.

The NRA reports that the industry has responded enthusiastically to the program. When it was first launched in 2011, 19 restaurant brands signed up. Today, that figure has climbed to 145 chains that represent 42,000 locations around the country.  McGlockton also says many restaurants that originally started with one qualifying meal have since added additional healthful menu items.

“We've seen a tremendous growth rate, and that's fabulous,” McGlockton says. “The industry is making progress. But more work needs to be done.”

The industry also is applying its creativity toward creating dishes that will appeal to kids. For the NRA's second annual Kids LiveWell Recipe Challenge, the winners were:

O’Charley’s casual-dining chain with its Cloudy with a Chance of Spaghetti and Meatball Pizza on whole wheat crust; Bean Sprouts Cafe & Cooking School with its Do-Re-For-Me sandwich, containing sunflower butter and organic strawberry jam served on an organic multigrain oat bread and cut in piano-key shaped pieces;

Sysco Hampton Road's Kids Quesa WOW Dill, with chicken, broccoli, peppers and corn served on a whole wheat tortilla; and University of Wisconsin-Madison Health's Swimming Taco with fish served on a whole-wheat tortilla with diced mango, cabbage and lime and cilantro.

Menumakers also are citing turkey as being a versatile component in the creation of healthful kids' menus. “Turkey is a leaner protein, and we're seeing a lot more innovation with its use on kids' menus,” McGlockton says.

In particular, turkey is showing up increasingly in the form of turkey burgers. According to Datassential, 20 percent of all restaurants offering hamburgers in 2013 menued a turkey burger. In addition, turkey burger menu penetration has more than doubled since 2005 and increased nearly 10 percent between 2012 and 2013.

And while a growing number of operators are menuing turkey burgers as lean protein options for adults, many are incorporating them as kids’ items as well. For example, Red Robin Gourmet Burger offers a Rad Robin Burger, which is available with a choice of turkey, beef, grilled chicken or veggie; while Ruby Tuesday features Turkey Minis for kids.

A freshly made turkey burger is available at Larkburger, a fast-casual, chef-driven concept based in Denver that was spun off from the high-end Larkspur Restaurant in Vail, Colo. Co-founder and chef Thomas Salamunovich says the 13-unit burger-centric chain offers a range of items “that haven't been dumbed down for kids.”

For example, the concept's 6-oz. turkey burger is available with half the meat as the Little Turkey. Larkburger used ground turkey thigh meat that is mixed with ginger, garlic, chicken and turkey stock, and other seasonings. It is served on a small, freshly toasted Brioche bun and topped with lettuce, tomato and onion.

Turkey also is available at Larkburger served in a salad of Bibb lettuce with tomato, quinoa, chickpeas, vegetables, Lola Rosa, and a Dijon mustard vinaigrette.

Salamunovich estimates that turkey items account for between 8 percent and 10 percent of sales. “Turkey is a great meat that takes on so many wonderful flavors,” he says. “It's unbelievably versatile.”

Salamunovich says the chain, which is located in Colorado, is planning to open an eastern outpost in New York City in the near future.

Turkey also is featured at the 14-unit Silver Diner chain. The 25-year-old East Coast brand takes its kids' menu so seriously it has brought in panels of children between the ages of 5- and 12-years old to test items before they're introduced on the menu, says chef and co-owner Ype Von Hengst. In 2013 some 30 kids participated, tasting about 20 different items.

The Silver Diner's kids' tasting event — which now has been held three times —  helped win the chain the Nation's Restaurant News' MenuMasters award for Healthful Innovations on its kids’ menu in 2013. The chain also removed French fries, home fries and soda from the printed menu.

Turkey burgers also are part of Silver Diner's kids' menu. Von Hengst says the chain's Mini Turkey Burgers are made with freshly ground turkey and served with steamed vegetables or a small side salad. On a recent menu, the Silver Diner also featured a gluten-free Spaghetti and Turkey Meatballs, with organic quinoa pasta. While they are currently off the summer menu, Von Hengst says he intends to bring turkey meatballs back in the fall, perhaps served with pesto.

The chain also offers roasted turkey with brown rice, vegetables, cranberry sauce and turkey gravy.

“Turkey generally sells well,” he says. “Kids love turkey.”