Increased portion sizes from energy-dense foods affect total energy intake at eating occasions in US children and adolescents: patterns and trends by age group and sociodemographic characteristics, 1977-2006.

BACKGROUND: Larger portion sizes of foods and beverages could affect overall energy intake at meals and promote overeating.

OBJECTIVE: We investigated trends in portion sizes of energy-dense foods and energy intakes at eating occasions in US children and adolescents.

DESIGN: Four US nationally representative surveys from 1977 to 2006 were analyzed (n = 31,337). We measured trends in portion sizes (kcal, g, and mL) of selected foods [sugar-sweetened beverages (SSBs), salty snacks, desserts, French fries, burgers, pizzas, and Mexican fast foods] and energy intake (kcal) at eating occasions during which selected foods were consumed. Trends were reported by age group (2-6-, 7-12-, and 13-18-y-olds), sex, and socioeconomic status.

RESULTS: In 2003-2006, the selected foods accounted for 38% of daily energy intake in 13-18-y-olds, 35% of the daily energy intake in 7-12-y-olds, and 28% of the daily energy intake in 2-6-y-olds. In all age groups, larger portion sizes of pizza coincided with higher energy intakes at eating occasions during which pizzas were consumed. In 7-12- and 13-18-y-olds, higher energy intakes at meals coincided with larger portion sizes of SSBs, French fries, or salty snacks. In all age groups, nonsignificant larger portions of Mexican fast foods were related to higher energy intakes at meals. Adolescent boys consumed larger portion sizes of the selected foods and had higher energy intakes at meals for all periods than did girls (P < 0.01). The percentage of kilocalories from pizza within a meal increased more sharply in non-Hispanic African Americans, in Hispanics, and in the group with a low household education than in the other groups.

CONCLUSIONS: Adolescents are more susceptible to increased portion sizing than are younger children. The group of non-Hispanic African Americans and Hispanics and individuals with a lower education represents key concerns for public health policies.