Advertisement

Relationship between Portion Size and Energy Intake among Infants and Toddlers: Evidence of Self-Regulation

      Abstract

      Objectives

      To assess whether dietary intakes of infants and young toddlers show evidence of energy self-regulation.

      Design

      Data from 24-hour recalls collected in the 2002 Feeding Infants and Toddlers Study were analyzed. Multivariate regressions were used to explore the relationship between portion size and usual energy intake as well as the relationship between portion size, number of eating occasions, number of unique foods, and energy density.

      Subjects/Setting

      A national random sample of 3,022 US infants and toddlers 4 to 24 months of age.

      Statistical Analyses Performed

      To measure variability in portion size, an average portion size z score was computed for each child in the sample, across 45 different food groups. The number of eating occasions was defined as the total number of times a child had anything to eat or drink during the day, excluding eating occasions that included only water and/or supplements. The total number of unique foods in a day was defined as the number of unique food codes included in the 24-hour recall, and energy density was computed as kilocalories/gram, including all foods, beverages, and water. Linear regression models were used to assess the effect of portion size and other self-regulation mechanisms on energy intake and to assess the effect of these self-regulation mechanisms on portion size. Separate analyses were performed for three age groups: 4 to 5 months, 6 to 11 months, and 12 to 24 months.

      Results

      A significant negative association was found for all age groups between the number of eating occasions and average portion size z scores, indicating that children who eat less often during the day consume larger-than-average-portion sizes and children who eat more often during the day consume smaller-than-average portions. For infants (11 months and younger), a significant negative association was noted between energy density and average portion size z scores, indicating that, as the energy density of the diet goes down, infants consume larger-than-average portions and, as the energy density of the diet goes up, they consume smaller-than-average portions. Among infants 6 to 11 months, there was a significant positive relationship between portion size and the number of unique foods consumed. For toddlers, there was no association between average portion size z scores and energy density, suggesting that energy self-regulation mechanisms are diminished in this age group.

      Conclusions

      Our findings confirm the presence of energy self-regulation among infants and young toddlers. These findings can be used to assure parents and caregivers that infants have an innate ability to regulate energy intake. At the same time, it is important to educate parents and caregivers about the potential for environmental cues to diminish natural hunger-driven eating behaviors, even among young toddlers. Dietetics professionals should emphasize the potential adverse effects that coercive feeding behaviors can have on children’s innate ability to regulate energy intake. This includes not only admonitions to “clean your plate,” but overrestriction of intake that may be motivated by concerns that children are overeating.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of the Academy of Nutrition and Dietetics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Young L.R.
        • Nestle M.
        The contribution of expanding portion sizes to the US obesity epidemic.
        Am J Public Health. 2002; 92: 246-249
        • Hill J.O.
        • Peters J.C.
        Environmental contributions to the obesity epidemic.
        Science. 1998; 280: 1371-1374
        • Rolls B.J.
        • Morris E.L.
        • Roe L.S.
        Portion size of food affects energy intake in normal-weight and overweight men and women.
        Am J Clin Nutr. 2002; 76: 1207-1213
        • Lavitsky D.A.
        • Youn T.
        The more food young adults are served, the more they overeat.
        J Nutr. 2004; 134: 2546-2549
        • Kral T.V.
        • Roe L.S.
        • Rolls B.J.
        Combined effects of energy density and portion size on energy intake in women.
        Am J Clin Nutr. 2004; 79: 962-968
        • Rolls B.J.
        • Roe L.S.
        • Meengs J.S.
        • Wall D.E.
        Increasing the portion size of a sandwich increases energy intake.
        J Am Diet Assoc. 2004; 104: 367-372
        • Rolls B.J.
        • Engell D.
        • Birch L.L.
        Serving portion size influences 5-year-old but not 3-year-old children’s food intakes.
        J Am Diet Assoc. 2000; 100: 232-234
        • McConahy K.L.
        • Smiciklas-Wright H.
        • Birch L.L.
        • Mitchell D.C.
        • Picciano M.F.
        Food portions are positively related to energy intake and body weight in early childhood.
        J Pediatr. 2002; 140: 340-347
        • McConahy K.L.
        • Smiciklas-Wright H.
        • Mitchell D.C.
        • Picciano M.F.
        Portion size of common foods predicts energy intake among preschool-aged children.
        J Am Diet Assoc. 2004; 104: 975-979
        • Shea S.
        • Basch C.E.
        • Contento I.R.
        • Zybert P.
        Variability and self-regulation of energy intake in young children in their everyday environment.
        Pediatrics. 1992; 90: 542-546
        • Birch L.L.
        • Fisher J.O.
        Development of eating behaviors among children and adolescents.
        Pediatrics. 1998; 101: 539-549
        • Adair L.S.
        The infant’s ability to self-regulate caloric intake.
        J Am Diet Assoc. 1984; 84: 543-546
        • Dewey K.G.
        Nutrition, growth, and complementary feeding of the breastfed infant.
        Pediatr Clin North Am. 2001; 48: 87-104
        • Birch L.L.
        • Davison K.K.
        Family environmental factors influencing the developing behavioral controls of food intake and childhood overweight.
        Pediatr Clin North Am. 2001; 48: 893-907
        • Wilson J.F.
        Preschool children maintain intake of other foods at a meal including sugared chocolate milk.
        Appetitie. 2000; 16: 61-67
        • Devaney B.
        • Kalb L.
        • Briefel R.
        • Zavitsky-Novak T.
        • Clusen N.
        • Ziegler P.
        Feeding Infants and Toddlers Study.
        J Am Diet Assoc. 2004; 104: S8-S13
        • Ziegler P.
        • Briefel R.
        • Clusen N.
        • Devaney B.
        Feeding Infants and Toddlers Study (FITS).
        J Am Diet Assoc. 2006; 106: S12-S27
        • Devaney B.
        • Ziegler P.
        • Pac S.
        • Karwe V.
        • Barr S.I.
        Nutrient intakes of infants and toddlers.
        J Am Diet Assoc. 2004; 104: S14-S21
        • Fox M.K.
        • Pac S.
        • Devaney B.
        • Jankowski L.
        Feeding Infants and Toddlers Study.
        J Am Diet Assoc. 2004; 104: S22-S30
        • Briefel R.
        • Reidy K.
        • Karwe V.
        • Devaney B.
        Feeding Infants and Toddlers Study.
        J Am Diet Assoc. 2004; 104: S31-S37
        • Skinner J.D.
        • Ziegler P.
        • Ponza M.
        Transitions in infants’ and toddlers’ beverage patterns.
        J Am Diet Assoc. 2004; 104: S45-S50
        • Carruth B.R.
        • Ziegler P.
        • Gordon A.
        • Hendricks K.
        Developmental milestones and self-feeding behaviors in infants and toddlers.
        J Am Diet Assoc. 2004; 104: S51-S56
        • Carruth B.R.
        • Ziegler P.
        • Gordon A.
        • Barr S.
        Prevalence of picky eaters among infants and toddlers and their caregivers’ decisions about offering a new food.
        J Am Diet Assoc. 2004; 104: S57-S64
        • Skinner J.D.
        • Ziegler P.
        • Pac S.
        • Devaney B.
        Meal and snack patterns of infants and toddlers.
        J Am Diet Assoc. 2004; 104: S65-S70
        • Ponza M.
        • Devaney B.
        • Ziegler P.
        • Reidy K.
        • Squatrito C.
        Nutrient intakes and food choices of infants and toddlers participating in WIC.
        J Am Diet Assoc. 2004; 104: S71-S79
        • Institute of Medicine. Food and Nutrition Board
        Dietary Reference Intakes. National Academy Press, Washington, DC1999
        • Institute of Medicine. Food and Nutrition Board
        Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids. National Academy Press, Washington, DC2000
        • Institute of Medicine
        • Food and Nutrition Board
        Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline. National Academy Press, Washington, DC2000
        • Institute of Medicine
        • Food and Nutrition Board
        Dietary Reference Intakes. National Academy Press, Washington, DC2002
        • Institute of Medicine
        • Food and Nutrition Board
        Dietary Reference Intakes. National Academy Press, Washington, DC2002
        • Institute of Medicine
        • Food and Nutrition Board
        Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate. National Academy Press, Washington, DC2004
        • Smiciklas-Wright H.
        • Mitchell D.C.
        • Mickle S.J.
        • Cook A.J.
        • Goldman J.D.
        Foods Commonly Eaten in the United States. 2002 (US Department of Agriculture NFS Report No. 96-5, pre-publication version. Available at: www.barc.usda.gov/bhnrc/foodsurvey/Products9496.html. Accessed September 2004.)
        • Krebs-Smith S.M.
        • Guenther P.M.
        • Cook A.J.
        • Thompson F.E.
        • Cucinelli J.
        • Udler J.
        Foods Commonly Eaten in the United States. US Department of Agriculture, Agricultural Research Service, Hyattsville, MD1997 (NFS Report No. 91-3;)
        • Fox M.K.
        • Reidy K.
        • Karwe V.
        • Ziegler P.
        Average portions of foods commonly eaten by infants and toddlers in the United States.
        J Am Diet Assoc. 2006; 106: S66-S76
        • Iowa State University, Center for Agricultural and Rural Development
        A User’s Guide to C-SIDE, Software for Intake Distribution Estimation, Version 1.0. Iowa State University, Center for Agricultural and Rural Development, Ames, IA1996
        • Birch L.L.
        • Fisher J.O.
        Food intake regulation in children. Fat and sugar substitutes and intake.
        Ann NY Acad Sci. 1997; 819: 194-220
        • Birch L.L.
        • McPhee L.
        • Shoba B.C.
        • Steinberg L.
        • Krehbiel R.
        “Clean up your plate”.
        Learn Motiv. 1987; 18: 301-317
        • Gillman M.W.
        • Rifas-Shiman S.L.
        • Camargo C.A.J.
        Risk of overweight among adolescents who were breastfed as infants.
        JAMA. 2001; 285: 2461-2467
        • Bergmann K.E.
        • Bergmann R.L.
        • Von Kries R.
        Early determinants of childhood overweight and adiposity in a birth cohort study.
        Int J Obes Relat Metab Disord. 2003; 27: 162-172
        • Taveras E.
        • Scanlon K.S.
        • Birch L.L.
        • Rifas-Shiman S.L.
        • Rich-Edmonds J.W.
        • Gilman M.W.
        Association of breastfeeding with maternal control of infant feeding at age 1 year.
        Pediatrics. 2004; 114: 577-583
        • US Department of Agriculture, Agricultural Research Service
        Food and Nutrient Intakes by Children 1994-96, 1998. 1999; (Available at: http://www.barc.usda.gov/bhnrc/foodsurvey/home.htm. Accessed June 6, 2005.)
        • Cole N.
        • Fox M.K.
        Nutrition and Health Characteristics of Low-Income Populations, Volume II. 2004; (US Department of Agriculture, Economic Research Service, Electronic publication number E-FAN-04-010-2. Available at: http://www.ers.usda.gov. Accessed June 16, 2005.)
        • Heinig M.J.
        • Nommsen L.A.
        • Peerson J.M.
        • Lonnderal B.
        • Dewey K.G.
        Energy and protein intakes of breast-fed and formula-fed infants during the first year of life and their association with growth velocity.
        Am J Clin Nutr. 1993; 58: 152-161
        • Satter E.
        Comments from a practitioner on Leann Birch’s research.
        J Am Diet Assoc. 1987; 87: S41-S43

      Biography

      M. K. Fox is a senior researcher, Mathematica Policy Research, Inc, Cambridge, MA; at the time of the study, she was an independent consultant.

      Biography

      B. Devaney is vice president, Human Services Research, Mathematica Policy Research, Inc, Washington, DC.

      Biography

      C. Razafindrakoto is senior programmer/analyst, Mathematica Policy Research, Inc, Princeton, NJ.

      Biography

      K. Reidy is director of nutrition and regulatory affairs, Gerber Products Co, Parsippany, NJ.

      Biography

      P. Ziegler is an adjunct, assistant professor, Department of Foods and Nutrition, College of Saint Elizabeth, Morristown, NJ; at the time of the study, she was a principal scientist, Gerber Products Co, Parsippany, NJ.