Energy Intake and Meal Portions: Associations with BMI Percentile in U.S. Children

Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA.
Obesity research (Impact Factor: 4.95). 12/2004; 12(11):1875-85. DOI: 10.1038/oby.2004.233
Source: PubMed

ABSTRACT We examined relationships of eating patterns and reported energy intake (rEI) with BMI percentile in U.S. children.
Two 24-hour dietary recalls from the Continuing Surveys of Food Intakes by Individuals 1994 to 1996 and 1998 (1005 boys, 990 girls) were averaged, and children were categorized into three age groups: 3 to 5 years (n = 1077), 6 to 11 years (n = 537), and 12 to 19 years (n = 381). Physiologically implausible reports due to reporting bias or abnormal intake (rEI outside +/-18% to 23% of predicted energy requirements; pER) were identified.
rEI averaged 109 +/- 34% and 100 +/- 10% of pER in the total and plausible samples, respectively. EI was overreported more in younger children and underreported more in overweight older children. Children with plausible rEI (45.3% of sample) averaged 4.7 eating occasions/d, 589 kcal/meal, 223 kcal/snack, and 2038 kcal/d. rEI was not associated with BMI percentile in the total sample. In the plausible sample, rEI, meal portion size, and meal energy were positively associated with BMI percentile in boys 6 to 11 years and in children 12 to 19 years. No relationships were found in children 3 to 5 years and girls 6 to 11 years. Relationships were more consistent and stronger in the plausible compared with the total sample.
Excluding implausible dietary reports may be necessary for discerning dietary associations with BMI percentile. EI and meal, but not snack, patterns may play a quantitatively greater role in weight regulation as children age.

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Available from: Terry Huang, Aug 23, 2015
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    • "It is worth noting however that this may be due to the limitations of self-or parent-reported caloric intake, as both adults and children are known to have great difficulty in accurately reporting EI [50] [51] [52]. For example, Huang and colleagues report that fully 55% of children aged 3–19 who participated in the Continuing Surveys of Food Intakes by Individuals study reported physiologically implausible values for energy intake, and that excluding these individuals resulted in dramatic improvements in both the strength and the consistency of the relationship between EI and body weight [52]. "
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    ABSTRACT: As a group, Canadian children and youth are heavier than at any time in the recent past. However, to date there has been no critical examination of the factors which are likely to have contributed to these deleterious trends. A review of the evidence suggests that there is robust evidence supporting the role of reduced sleep, increased sedentary time, increased consumption of sugar-sweetened beverages, and secular increases in adult obesity as contributing factors to the current epidemic of childhood obesity. There is moderate evidence that these trends are related to changes in either total energy intake or physical activity, while there is very little evidence supporting the role of maternal age, breastfeeding, exposure to endocrine disrupters, or inadequate calcium intake. These findings suggest that targeting sleep, sedentary time, and sugar-sweetened beverage intake in Canadian children and youth may help to prevent future weight gain at the population level.
    12/2011; 2011:917684. DOI:10.5402/2011/917684
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    • "ts to meet the specific stages of growth and development ( Allen , 2006 ) . The analysis of the national database from Contin - uing Surveys of Food Intake shows that 3 - to 5 - year - old children have an eating frequency of five meals with 2 . 3 snack times with meal energy density of 1 . 11 kcal ⁄ g and snack energy density of 1 . 34 kcal ⁄ g ( Huang et al . , 2004 ) . In this study , the preschool meals provided an average energy density ( excluding beverages ) of 1 . 48 kcal ⁄ g , which was slightly higher than the reference energy density of 1 . 29 kcal ⁄ g ( Fisher , Liu , Birch , & Rolls , 2007 ) . Several experimental studies have shown that both larger portion sizes and higher energy densit"
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    09/2009; 38(1):11-25. DOI:10.1111/j.1552-3934.2009.00002.x
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    • "As the incidence of overweight and obesity has escalated, a corresponding increase in the portion size of foods served in restaurants and fast food establishments has occurred. Huang, Howarth, and Linn (2004) reported that portion size was positively associated with BMI percentile in boys aged 6-11 years and in adolescents aged 12-19 years, but not in 3-5 year olds. In children, satiety cues may start to be overridden by environmental cues, including pressure from parents to " clean up their plate, " enabling the preference for larger portions (Fitzgerald, Taper, & Veugelers, 2007). "
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