Reducing the Energy Density of an Entrée 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 entrée 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 entrée were formulated to differ in energy density while maintaining similar palatability. Each version was served to children three times. The higher-energy-density entrée had 2.0 kcal/g and the other entrée 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 entrée on food intake and energy intake. Results are reported as mean±standard error. Results: Decreasing the energy density of the entrée by 30% significantly (P<0.0001) reduced children's energy intake from the entrée 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 entrée (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 entrée and children's intakes. Conclusions: Decreasing the energy density of a lunch entrée resulted in a reduction in children's energy intake from the entrée and from the total meal. Reducing the energy density of foods may be an effective strategy to moderate children's energy intake.