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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.

SUBMITTER: Smethers AD

PROVIDER: S-EPMC6499504 | biostudies-literature | 2019 May

REPOSITORIES: biostudies-literature

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

Smethers Alissa D AD Roe Liane S LS Sanchez Christine E CE Zuraikat Faris M FM Keller Kathleen L KL Kling Samantha M R SMR Rolls Barbara J BJ

The American journal of clinical nutrition 20190501 5

<h4>Background</h4>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.<h4>Objectives</h4>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.<h ...[more]

PMID: 30976782

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Project description:BACKGROUND:Large portion sizes encourage overconsumption. Prior studies suggest that this may be due to errors in anticipating the effects of portion size, although the studies were limited to adults and energy-dense foods. OBJECTIVE:Our aim was to investigate potential anticipation errors related to the effects of portion size on hunger, eating enjoyment, and healthiness ratings among 8-to-11-year-old children, for snacks differing in energy density and healthiness perception, and as a function of initial hunger. METHODS:In a within-subject design, 83 children aged 8 to 11?years old were first asked to anticipate how much they would enjoy, how hungry they would feel after eating, and how healthy it would be to eat a recommended serving size, a 50% larger portion, and a 125% larger portion of brownie or applesauce. Over six subsequent sessions, the children were asked to eat all of each of these portions and then rate their post-intake enjoyment, residual hunger, and healthiness perceptions. We also measured hunger at the beginning of each session. RESULTS:For both snacks, larger portions reduced anticipated and experienced residual hunger similarly. In contrast, larger portions increased anticipated but not experienced eating enjoyment for both snacks; although larger portions increased anticipated and experienced enjoyment ratings among extremely hungry children. All children under-anticipated how much they would enjoy the smaller portion sizes. Healthiness ratings were unaffected by portion size for both snacks but differed across foods (applesauce vs. brownie). CONCLUSIONS:Children anticipate the effects of portion size on hunger change accurately, overestimate the effects of portion size on eating enjoyment, and rate food healthiness on food type and not portion size. Helping children better anticipate the enjoyment from smaller (recommended) portion sizes and understand that food quantity, not just quality, matters for healthy eating may be a solution to improve portion control.

Project description:ObjectiveStuttering is a common childhood disorder. There is limited high quality evidence regarding options for best treatment. The aim of the study was to compare the effectiveness of direct treatment with indirect treatment in preschool children who stutter.MethodsIn this multicenter randomized controlled trial with an 18 month follow-up, preschool children who stutter who were referred for treatment were randomized to direct treatment (Lidcombe Program; n = 99) or indirect treatment (RESTART-DCM treatment; n = 100). Main inclusion criteria were age 3-6 years, ≥3% syllables stuttered (%SS), and time since onset ≥6 months. The primary outcome was the percentage of non-stuttering children at 18 months. Secondary outcomes included stuttering frequency (%SS), stuttering severity ratings by the parents and therapist, severity rating by the child, health-related quality of life, emotional and behavioral problems, and speech attitude.ResultsPercentage of non-stuttering children for direct treatment was 76.5% (65/85) versus 71.4% (65/91) for indirect treatment (Odds Ratio (OR), 0.6; 95% CI, 0.1-2.4, p = .42). At 3 months, children treated by direct treatment showed a greater decline in %SS (significant interaction time x therapy: β = -1.89; t(282.82) = -2.807, p = .005). At 18 months, stuttering frequency was 1.2% (SD 2.1) for direct treatment and 1.5% (SD 2.1) for indirect treatment. Direct treatment had slightly better scores on most other secondary outcome measures, but no differences between treatment approaches were significant.ConclusionsDirect treatment decreased stuttering more quickly during the first three months of treatment. At 18 months, however, clinical outcomes for direct and indirect treatment were comparable. These results imply that at 18 months post treatment onset, both treatments are roughly equal in treating developmental stuttering in ways that surpass expectations of natural recovery. Follow-up data are needed to confirm these findings in the longer term.Trial registrationisrctn.org ISRCTN24362190.

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

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

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