Overweight very young children consume larger meals

It has been the subject of much debate whether individuals become overweight because they eat too much at each eating occasion (have larger 'meal sizes') and/or eat too often ( have a higher 'meal frequency') compared with individuals of a healthy weight. However, in spite of the concern about childhood obesity, this topic has been under-researched in young children. In this study, the authors used parent- reported intake for very young children from a large national dietary dataset in the UK to study meal size and meal frequency in relation to weight.

The researchers used diet diaries collected in 2564 children aged 4-18 months from the 2011 national DNSIYC survey. The team found that overweight children were consuming larger meals than the healthy weight children (141 calories versus 130 calories, respectively at each eating occasion), but they were not eating any more frequently throughout the course of the day. For every extra 24 calories (100 kJ) consumed during each meal, there was a 9% increased risk of overweight/obesity. Importantly, the overweight children appeared to be consuming more calories than the healthy weight children by eating larger portions of the same types of foods (160g versus 146g), because there was no difference in the energy density of the meals (kJ/gram) consumed between overweight and healthy weight children.

The authors conclude: "Larger portions rather than eating more often may be a risk factor for the development of childhood overweight in early life. Further prospective studies that look at the development of excess weight over time are needed to establish causation."

They add: "Although the difference in average meal size between the overweight and healthy weight children seems small (11 calories, perhaps an extra spoonful of baked beans with a meal) children are eating on average 5 times per day so the difference over the course of a week is considerable. An excess of 11 calories per meal equates to an extra 56 calories per day, an extra 393 calories per week, and an extra 1703 calories per month. This small extra intake each meal means that overweight children are consuming approximately 2 extra days' worth of energy each month. Given that these children are less than two years of age, over time the effects could be substantial. Our research highlights the need for better guidance on portion sizes* for infants and young children."