Reducing the energy density of an entree decreases children's energy intake at lunch

Background Strategies need to be developed to reduce preschool children's energy intake. Objective To test the effect of reducing the energy density of an entree on children's ad libitum energy intake. Subjects Subjects were 2- to 5-year-old children (37 boys and 40 girls) in a university day-care facility. Intervention In this within-subjects crossover study, children were served a test lunch once per week for 6 weeks. Two versions of a macaroni and cheese entree were formulated to differ in energy density while maintaining similar palatability. Each version was served to children three times. The higher-energy-density entree had 2.0 kcal/g and the other entree was 30% lower in energy density. Lunch, consumed ad libitum, also included broccoli, applesauce, and milk. Main outcome measures Food intake and energy intake were measured. Statistical analyses A mixed linear model tested effect of energy density of the entree on food intake and energy intake. Results are reported as mean +/- standard error. Results Decreasing the energy density of the entree by 30% significantly (P<0.0001) reduced children's energy intake from the entree by 25% (72.3 +/- 8.3 kcal) and total lunch energy intake by 18% (71.8 +/- 7.9 kcal). Children consumed significantly more of the lower-energy-density entree (10.1 +/- 4.2 g; P<0.05). Children's sex-specific body mass index-for-age percentiles did not affect the relationship between energy density of the entree and children's intakes. Conclusions Decreasing the energy density of a lunch entree resulted in a reduction in children's energy intake from the entree and from the total meal. Reducing the energy density of foods may be an effective strategy to moderate children's energy intake.