Portion size has sustained effects over 5 days in preschool children: a randomized trial

• Published in: The American journal of clinical nutrition Vol. 109; no. 5; pp. 1361 - 1372
• Main Authors: Smethers, Alissa D, Roe, Liane S, Sanchez, Christine E, Zuraikat, Faris M, Keller, Kathleen L, Kling, Samantha M R, Rolls, Barbara J
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.2019; American Society for Clinical Nutrition, Inc; Oxford University Press
• Subjects: Body Weight; Child Nutritional Physiological Phenomena; Child, Preschool; Children; Cross-Over Studies; Crossovers; Eating - psychology; eating behavior; Energy Intake; Feeding Behavior - psychology; Female; Food; Food intake; Humans; Hyperphagia - psychology; Male; obesity; Obesity - etiology; Original Research Communications; Overweight; Pediatric Obesity - etiology; Pediatric Obesity - psychology; Portion Size; Preschool children; Psychology, Child; Ratings; Satiation; Satiety; Satiety Response; Self-Control; Size effects; preschool children; energy intake; eating behavior; obesity; CEBQ; CFSQ; portion size; CFQ
• ISSN: 0002-9165; 1938-3207
• DOI: 10.1093/ajcn/nqy383

Although short-term studies have found that serving larger portions of food increases intake in preschool children, it is unknown whether this portion size effect persists over a longer period or whether energy intake is moderated through self-regulation. We tested whether the portion size effect is sustained in preschool children across 5 consecutive days, a period thought to be sufficient for regulatory systems to respond to the overconsumption of energy. With the use of a crossover design, over 2 periods we served the same 5 daily menus to 46 children aged 3–5 y in their childcare centers. In 1 period, all foods and milk were served in baseline portions, and in the other period, all portions were increased by 50%. The served items were weighed to determine intake. Increasing the portion size of all foods and milk by 50% increased daily consumption: weighed intake increased by a mean ± SEM of 143±21 g/d (16%) and energy intake increased by 167±22 kcal/d (18%; both P<0.0001). The trajectories of intake by weight and energy across the 5-day period were linear and the slopes did not differ between portion conditions (both P>0.13), indicating that there were sustained increases in intake from larger portions without compensatory changes over time. Children differed in their response to increased portions: those with higher weight status, lower ratings for satiety responsiveness, or higher ratings for food responsiveness had greater increases in intake from larger portions (all P<0.03). This demonstration that preschool children failed to adjust their intake during prolonged exposure to larger portions challenges the suggestion that their self-regulatory behavior is sufficient to counter perturbations in energy intake. Furthermore, overconsumption from large portions may play a role in the development of overweight and obesity, as the magnitude of the effect was greater in children of higher weight status. This trial was registered at www.clinicaltrials.gov as NCT02963987.