Causes of Increased Energy Intake Among Children in the U.S., 1977–2010

Abstract

Background Changes in total energy (TE) intake have been reported among children and adolescents, but the extent to which the components of total energy—energy density (ED); portion size (PS); and the number of eating/drinking occasions (EO)—drive these changes is unknown. Purpose The objective of the current study was to examine the relative contribution to changes in daily total energy. Methods Using cross-sectional nationally representative data from the Nationwide Food Consumption Survey (1977–1978); the Continuing Survey of Food Intake of Individuals (1989–1991); and the National Health and Nutrition Examination Surveys (1994–1998 and 2005–2010) for children and adolescents (aged 2–18 years), changes in total energy (kcal/day) are mathematically decomposed to determine the relative contributions of its three component parts: portion size (g/EO); energy density (kcal/g/EO); and eating/drinking occasions (#). Analyses were completed in 2012. Results Over the full period, there was an increase in total energy intake (+108 kcal/day) and the number of daily eating/drinking occasions (+1.2). The average portion size per eating/drinking occasion increased between 1977–1978 and 1989–1991, then dropped by about 85g/EO between 1989–1991 and 2005–2010. The average energy density per eating/drinking occasion has fluctuated over time, reaching its highest level in 2005–2010 (1.24 kcal/g/EO). The decomposition results show that between 1977–1978 and 2005–2010, changes in the number of eating/drinking occasions per day and portion size per eating occasion were the largest contributors to annualized changes in daily total energy (+19 kcal/day/year and −13 kcal/day/year, respectively). Variations in trends were observed for race/ethnicity and parental education subgroups. Conclusions These findings highlight potentially important intervention targets for reducing energy imbalances in U.S. youth.

Heart Disease and Stroke Statistics—2017 Update: A Report From the American Heart Association

“…38,39 Changes in energy density were not consistently linked to energy intake over time, whereas increases in both portion size and number of eating occasions were linked to greater energy intake.…”

“…38,39 However, data from NHANES indicate that between 1971 and 2004, average total energy intake among US adults increased by 22% in females (from 1542 to 1886 kcal/d) and by 10% in males (from 2450 to 2693 kcal/d). 40 These increases are supported by data from 2 older surveys, the Nationwide Food Consumption Survey (1977–1978) and the Continuing Surveys of Food Intake (1989–1998).…”

Influencing and modifying children's energy intake: the role of portion size and energy density

“…There is evidence to suggest that by the age of 1-2 years, children may no longer be immune to the intake-enhancing effects of large PS (40)(41)(42) . It should also be remembered that EI is a function of both the PS of a food/beverage, as well as its ED and the frequency of consumption, among other factors (43,44) . Analyses of cross-sectional population level data in the USA have confirmed that over the past three decades, the observed increase in EI by both children over age 2 years and adults has largely been driven by a combination of increased eating frequency and PS (6,44,45) .…”

Dietary energy density in young children across Europe

“…Extensive research on dietary intakes in 2-8-year-old US children has shown an overall increase of energy density of the diet during the past decades. 4,[12][13][14] Literature on ED of diets in larger young European populations is still scarce and covers mainly studies from United Kingdom, 15,16 Spain,…”