To assess whether dietary intakes of infants and young toddlers show evidence of energy
self-regulation.
Data from 24-hour recalls collected in the 2002 Feeding Infants and Toddlers Study
were analyzed. Multivariate regressions were used to explore the relationship between
portion size and usual energy intake as well as the relationship between portion size,
number of eating occasions, number of unique foods, and energy density.
A national random sample of 3,022 US infants and toddlers 4 to 24 months of age.
To measure variability in portion size, an average portion size z score was computed
for each child in the sample, across 45 different food groups. The number of eating
occasions was defined as the total number of times a child had anything to eat or
drink during the day, excluding eating occasions that included only water and/or supplements.
The total number of unique foods in a day was defined as the number of unique food
codes included in the 24-hour recall, and energy density was computed as kilocalories/gram,
including all foods, beverages, and water. Linear regression models were used to assess
the effect of portion size and other self-regulation mechanisms on energy intake and
to assess the effect of these self-regulation mechanisms on portion size. Separate
analyses were performed for three age groups: 4 to 5 months, 6 to 11 months, and 12
to 24 months.
A significant negative association was found for all age groups between the number
of eating occasions and average portion size z scores, indicating that children who
eat less often during the day consume larger-than-average-portion sizes and children
who eat more often during the day consume smaller-than-average portions. For infants
(11 months and younger), a significant negative association was noted between energy
density and average portion size z scores, indicating that, as the energy density
of the diet goes down, infants consume larger-than-average portions and, as the energy
density of the diet goes up, they consume smaller-than-average portions. Among infants
6 to 11 months, there was a significant positive relationship between portion size
and the number of unique foods consumed. For toddlers, there was no association between
average portion size z scores and energy density, suggesting that energy self-regulation
mechanisms are diminished in this age group.
Our findings confirm the presence of energy self-regulation among infants and young
toddlers. These findings can be used to assure parents and caregivers that infants
have an innate ability to regulate energy intake. At the same time, it is important
to educate parents and caregivers about the potential for environmental cues to diminish
natural hunger-driven eating behaviors, even among young toddlers. Dietetics professionals
should emphasize the potential adverse effects that coercive feeding behaviors can
have on children's innate ability to regulate energy intake. This includes not only
admonitions to "clean your plate," but overrestriction of intake that may be motivated
by concerns that children are overeating.