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Title: Characterizing lunch meals served and consumed by pre-school children in Head Start

Author
item NICKLAS, THERESA - Children'S Nutrition Research Center (CNRC)
item LIU, YAN - Children'S Nutrition Research Center (CNRC)
item STUFF, JANICE - Children'S Nutrition Research Center (CNRC)
item FISHER, JENNIFER - Temple University
item MENDOZA, JASON - Children'S Nutrition Research Center (CNRC)
item O'NEIL, CAROL - LSU Agcenter

Submitted to: Public Health Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 4/11/2013
Publication Date: 12/15/2013
Citation: Nicklas, T.A., Liu, Y., Stuff, J.E., Fisher, J.O., Mendoza, J.A., O'Neil, C.E. 2013. Characterizing lunch meals served and consumed by pre-school children in Head Start. Public Health Nutrition. 16:2169-2177.

Interpretive Summary: Childhood obesity is a major public health problem. The National Health and Nutrition Examination Survey 2009–2010 data showed that nearly 15% of United States children aged 2–5 years were overweight, while 12% were obese. Key contributing factors to overweight and obesity in children have not been determined; however, most experts agree that weight gain occurs when dietary intake exceeds energy expenditure. Children's eating patterns are initiated early in life, suggesting that the pre-school period is a pivotal developmental time point during which healthful eating patterns may be fostered. Findings from our study showed that plate waste was high. Variation in the amounts served and consumed was substantial and the amounts served were positively associated with the amounts consumed. Finally, child characteristics influenced the amount of food served and consumed by pre-school children. Given that large portion sizes may contribute to the high prevalence of overweight among children by promoting excessive intake at meals, teaching pre-school children how to serve themselves appropriately sized amounts of food may help prevent obesity and reduce food waste.

Technical Abstract: The objective of this study was to examine the variability of food portions served and consumed by African-American and Hispanic-American pre-school children attending Head Start. It was a cross-sectional design. The participants were 796 pre-schoolers (3-5 years of age) enrolled in sixteen Head Start centers in Houston, Texas, and were assessed during 3 days of lunch meals using digital photography. Descriptive statistics and multilevel regression models, adjusting for classroom and school clustering effects, were determined. Mean amount served was 2428 kJ. Mean intake was 1421 kJ. Plate waste was 43%. Plate waste and variation in amounts served and consumed were substantial; amounts served were associated with amounts consumed. Large portion sizes may contribute to peadiatric obesity by promoting excessive intake at meals. Understanding factors influencing portion sizes provides insight about specific intervention strategies that can be used in obesity prevention programs.