In the past few years, consumer advocacy groups have pressed restaurant chains to offer healthier kids’ meals and more nutritious side options. Fast food chains have responded by replacing sugary soft drinks and greasy French fries with healthier options like fruit and yogurt, 100-percent juice, low-fat milk, and water. Is it making much of a difference? A new study says no.

According to a new survey, children in the US are eating fast food more often and most of them are still having unhealthy drinks and side items with their meals. For the report, the researchers surveyed approximately 800 parents in 2010, 2013, and 2016 about what they ordered for their 2- to 11-year-old child in the past week from one of the four largest chains in the country: McDonald’s, Burger King, Wendy’s, and Subway.

The survey found that in 2016, 91 percent reported purchasing lunch or dinner for their child in the past week at one of those restaurants, up from 79 percent in 2010. Seventy-four percent reported receiving unhealthy drinks and/or side items with their child’s meal. From 2013 to 2016, the percentage of parents who purchased kids’ meals with healthier sides actually declined from 67 percent in 2013 to 50 percent in 2016.

The lead author of the report, Jennifer Harris, director of marketing initiatives for the Rudd Center for Food Policy and Obesity at the University of Connecticut, said she was disappointed that there wasn’t an increase in purchases of healthier sides and drinks with kids’ meals. However, she wasn’t surprised.

The counter personnel at many fast food restaurants tend to automatically provide the less-healthy sides and drinks without offering the healthier items when a kids’ meal is ordered. “Parents should be given the healthy items automatically, or given the choice of healthy items if more than one are available, and the unhealthy items should be the ones that they have to ask for specifically,” Harris said.