San Francisco’s board of supervisors has voted, by a veto-proof margin, to ban most of McDonald’s Happy Meals as they are now served in the restaurants.

The measure will make San Francisco the first major city in the country to forbid restaurants from offering a free toy with meals that contain more than set levels of calories, sugar and fat.

The ordinance also would require restaurants to provide fruits and vegetables with all meals for children that come with toys.

“We’re part of a movement that is moving forward an agenda of food justice,” said Supervisor Eric Mar, who sponsored the measure. “From San Francisco to New York City, the epidemic of childhood obesity in this country is making our kids sick, particularly kids from low income neighborhoods, at an alarming rate. It’s a survival issue and a day-to-day issue.”

Just after the vote, McDonald’s spokeswoman Danya Proud said, “We are extremely disappointed with today’s decision. It’s not what our customers want, nor is it something they asked for.”

The ban, already enacted in a similar measure by Santa Clara County, was opposed by San Francisco Mayor Gavin Newsom, who was vying to be lieutenant governor in Tuesday’s election. But because the measure was passed by eight votes — one more than needed to override a veto — his opposition doesn’t matter unless one of the supervisors changes his or her mind after the promised veto.

Under the ordinance, scheduled to take effect in December 2011, restaurants may include a toy with a meal if the food and drink combined contain fewer than 600 calories, and if less than 35 percent of the calories come from fat.

Over the last few weeks, the proposed ban caused a stir online and on cable television, with supporters arguing that it would help protect children from obesity, and opponents seeing it as the latest example of the nanny state gone wild.

Supervisor Bevan Dufty, whose swing vote provided the veto-proof majority, said critics should not dismiss the legislation as a nutty effort by San Franciscans. “I do believe the industry is going to take note of this. I don’t care how much they say, ‘It’s San Francisco, they’re wacked out there.’”

Proud, the McDonald’s spokeswoman, said the city was out of step with the mainstream on the issue.

“Public opinion continues to be overwhelmingly against this misguided legislation,” she said. “Parents tell us it’s their right and responsibility — not the government’s — to make their own decisions and to choose what’s right for their children.”

Oakbrook-based McDonald’s is not the only fast-food chain to offer toys with children’s meals, but because it is so prominent the company has become a key face of opposition to the ban.

Daniel Conway, spokesman for the California Restaurant Association, bemoaned the ordinance’s passage and contrasted it with San Franciscans’ exuberant feelings after the Giants won the World Series on Monday night.

“One day you’re world champions, and the next day, no toys for you,” Conway said.

He said the industry could respond in a number of ways to the ordinance. Some might continue to include toys but charge separately for them. Others might reformulate their meals so that they comply with the law. Restaurants might also simply stop offering children’s meals altogether, he said.

Proud said the company does offer more healthful menu options, including apple slices that can be ordered with kids’ meals instead of french fries.

The vote was held the same day that McDonald’s reintroduced nationwide its McRib sandwich, a pressed pork patty that gets half its calories from fat and has a cultlike legion of fans.

Mar said it would lead the fast-food giant and other restaurants to provide more healthful food for kids. The ban, he said, was crucial to the fight against childhood obesity and the illnesses that go along with it, including diabetes and the risk of heart problems and stroke. The cost of fighting those diseases, he said, will be in the billions.

“It’s astronomical how much it’s going to cost if we don’t address it,” Mar said. “It’s incredible the crisis that’s going to hit us.”