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

Abstract

Background 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. Objectives 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. Methods 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. Results 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). Conclusions 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.

The third dimension of flavor: A chemesthetic approach to healthier eating (a review)

“…This leads to lower sensory satisfaction and high caloric intake (Cecil, Francis, & Read, 1999;Haber, Heaton, Murphy, & Burroughs, 1977;Smethers & Rolls, 2018;Viskaal-van Dongen, Kok, & de Graaf, 2011;Zijlstra, Mars, de Wijk, Westerterp-Plantenga, & de Graaf, 2008). Unfortunately, it has also been demonstrated that when people, both adults and kids, ingest a larger portion version of a meal or snack (intake increase of about 140-200 cal), they do not compensate for this in later meals, resulting in a higher daily average caloric intake (Forde, 2018;Rolls, Laster, & Summerfelt, 1989;Smethers et al, 2019). This effect was found to be more pronounced in those with lower satiety responsiveness, as determined by a validated questionnaire.…”

The portion size effect and overconsumption – towards downsizing solutions for children and adolescents – An update

“…This suggests that some children are more sensitive to the portion size served and confirms the findings of Smethers et al . () that poor satiety responsiveness predicts greater intake when large portions are served.…”

“…Of particular interest was the observation that individual differences were important in the response to the PSE, with bodyweight status and eating traits (lower satiety responsiveness and higher food responsiveness) predicting greater susceptibility to the PSE (Smethers et al . ).…”

“…Smethers et al . () have recently examined the long‐term effects of offering pre‐school children large portion sizes of foods and milk on total weight consumed and total daily energy intake across 5 days. The researchers provided breakfast, lunch, afternoon snack and dinner across consecutive days using a crossover design.…”

What guidance is there on portion size for feeding preschool‐aged children (1 to 5 years) in the United Kingdom and Ireland? A systematic grey literature review

“…Evidence shows that young children consume larger amounts of the manipulated foods, without a compensatory decrease in the intake of other foods, leading to greater energy intake during a single meal 8 . This effect has been shown to be sustained over several days 9 . Studies have also shown that increasing portion sizes of healthier foods such as milk and fruit alongside other foods results in increased consumption of these foods, without increasing total energy intake (kcal) of the meal 10, 11 .…”