It’s either a very curious coincidence or the biggest David and Goliath story in recent centuries, but within weeks of the national release of Morgan Spurlock’s film, Super Size Me, a scathing documentary on the ill effects of a month of McDonald’s, the fast food giant has done away with supersizing, and launched a line of “Go Active!” Happy Meals for adults.

Spurlock’s movie, in which the director subjected himself to 30 days on an all-McDonald’s meal plan, won a director’s award at this year’s Sundance Film Festival, and has garnered favorable reviews nationwide (see Holistic Primary Care Spring 2004). Putting the “Reality TV” concept to a public health end, the young filmmaker assembled a team of three physicians to monitor the physiologic changes that follow thrice daily dosing with Mickey D’s finest fare. Gross-out tactics aside, few public health education campaigns have had the sort of gut-level impact of this movie.

Whether or not Super Size Me awakened the dormant conscience of Ronald McDonald is debatable, but there’s no doubt the Big Yellow Clown is trying to remake his image from peddler of chronic disease to purveyor of good health.

In May, the company quietly announced that it has stopped the policy of supersizing (encouraging customers to purchase larger portions, extra fries or bigger soft drinks) and began offering “Go Active!” Happy Meals. Aimed at adults, these new meals give customers a choice of four “premium” salads, a bottle of Dasani® water (bottled by Coca Cola), a Stepometer, and a booklet entitled, “Step With It,” authored by Bob Greene, Oprah Winfrey’s personal trainer. The booklet is a walking guide that encourages customers to go at least 10,000 steps per day as part of a moderate activity plan.

To support the campaign, Mr. Greene himself will be hoofing and cycling through Golden Arches all through the South, as part of his 36-day Go Active! American Challenge. He’ll be accompanied by the 99% fat free former Miss Universe, Alicia Machado, and a number of other svelte spokespeople. The company has even re-introduced Willie Munchright, the claymation star of it’s nutrition education series, “What’s On Your Plate,” aimed at teaching school children about healthy eating habits.

Clearly McDonald’s newfound health consciousness is a step (excuse the pun) in the right direction. But taking fitness advice from a fast food colossus is a bit like letting oil companies make environmental regulations. Contradictions are bound to abound.

The McDonald’s website encourages customers to, “Get the straight facts on all your favorites,” and then provides macronutrient analyses of nearly everything served under the Arches. Holistic Primary Care did a little bit of “straight fact” finding on McDonald’s site, and the numbers for those Go Active! salads have us a little nervous.

For example, the “Premium Fiesta” salad, a Tex-Mex style item with spicy beef, jack cheese, sour cream and tortilla strips on a bed of mesclun greens, packs 420 calories, 27 grams of total fat (42% of the recommended daily value), 13 grams of saturated fat (65% of daily value), and 95 mg of cholesterol—even more than the chain’s signature Big Mac sandwich, which contains 11 g (57% of daily value) of saturated fat and 85 mg of cholesterol. A customer is going to have to get very active in order to burn all that off. And how anyone can make a salad that contains only 4 g of dietary fiber is beyond our reckoning.

Of course, customers can opt to omit the sour cream, knocking the Premium Fiesta’s total calorie count down to 360, and the saturated fat down to 10 g. But this “healthy” meal still carries 80 mg of cholesterol, and it is not like Mickey D heaps on extra leafies to make up for the dashed dollop of dairy. The creamless Fiesta still only has 4 grams of fiber. Perhaps customers should be asking “Where’s the Green?”

One also wonders why, if Uncle Ronald wants us to exercise more, did McDonald’s team up to celebrate ESPN’s 25th anniversary with a series of “ESPN25 Best in Sports” hand-held mini video game devices? True, these games feature the likenesses of tennis queens Venus and Serena Williams and hoop champ Vince Carter. But it is not like the physical fitness of these super athletes will filter through the screen via osmosis.

Contradictory though it all may seem, McDonald’s current interest in health does reflect a very promising fact: corporate leaders will respond to the demands of their customers. It would seem that Americans, spurred on by films like Super Size Me, and books like Eric Schlosser’s Fast Food Nation, not to mention the growing outcry from the medical community, are finally voicing their concerns about health and diet. Will we ever see Mc-robiotic options at the drive through? It depends on what we ask for.