Reductions in entree energy density increase children's vegetable intake and reduce energy intake

The energy density (ED; kcal/g) of an entree influences children's energy intake (EI), but the effect of simultaneously changing both ED and portion size of an entree on preschool children's EI is unknown. In this within-subject crossover study, 3- to 5-year-old children (30 boys, 31 girls) in a daycare facility were served a test lunch once/week for 4 weeks. The amount and type of vegetables and cheeses incorporated into the sauce of a pasta entree were manipulated to create two versions that varied in ED by 25% (1.6 or 1.2 kcal/g). Across the weeks, each version of the entree was served to the children in each of two portion sizes ( 400 or 300 g). Lunch, consumed ad libitum, also included carrots, applesauce, and milk. Decreasing ED of the entree by 25% significantly (P < 0.0001) reduced children's EI of the entree by 25% (63.1 +/- 8.3 kcal) and EI at lunch by 17% (60.7 +/- 8.9 kcal). Increasing the proportion of vegetables in the pasta entree increased children's vegetable intake at lunch by half of a serving of vegetables ( P < 0.01). Decreasing portion size of the entree by 25% did not significantly affect children's total food intake or EI at lunch. Therefore, reducing the ED of a lunch entree resulted in a reduction in children's EI from the entree and from the meal in both portion size conditions. Decreasing ED by incorporating more vegetables into recipes is an effective way of reducing children's EI while increasing their vegetable intake.