Serving smaller age-appropriate entree portions to children aged 3-5 y increases fruit and vegetable intake and reduces energy density and energy intake at lunch

Background: Previous portion size research in children has focused on the impact of large entree portions on children's intake, but less attention has been given to how intake at a meal is affected across a broader range of entree portions. Objective: The objective was to assess the effect of serving a range of entre portions on children's ad libitum intake and energy density consumed at the meal. Design: A within-subject design was used to examine the effect of varying entree portions (ie, 100, 160, 220, 280, 340, and 400 g) on children's ad libitum energy intake of macaroni and cheese and fixed portions of unsweetened applesauce, green beans, and whole-wheat roll served with the entree. Seventeen children (10 girls), aged 3 to 6 y, were served a series of 6 lunches, which varied only in entree portion size, once per week. Weight, height, and weighed food intake were measured. Results: Increasing portion size increased children's entree intake (P < 0.01) and decreased intake of other foods served with the entree, including fruit and vegetables (P < 0.0001). As a result, children consumed a more-energy-dense (kcal/g) lunch as portion size increased (P < 0.0001). Further examination showed that BMI percentile moderated the positive association between portion size and entree intake (P < 0.01); overweight children showed greater increases in entree intake with increasing entree portion. Conclusion: Serving smaller age-appropriate entree portions may be one strategy to improve children's nutritional profile by decreasing intake of energy-dense foods and by promoting intake of fruit and vegetables served with the entree. Am J Clin Nutr 2012;95:335-41.