Abstract
Large portion sizes of food can lead to excessive energy intake and weight gain in young children. Although portion size guidance is available, parents are often unaware it exists. Our systematic grey literature review aimed to identify the portion size guidance resources in the United Kingdom and Ireland, aimed at users (e.g., parents and childcare providers) responsible for feeding preschool-aged children. We describe who the resources are aimed at, how they are informed and whether the recommended portion sizes are consistent across resources. Resources were identified via advanced Google searches, searching reference lists and contacting experts. Resources that provided quantifiable portion size information (e.g., grammes) were included. Portion sizes (g) were extracted and energy equivalents (kcal) were calculated. Portion sizes were analysed by food group and by eating occasion. Twenty-two resources were identified. Median portion sizes were consistent across resources for fruit (40 g [IQR = 40-50]) and vegetables (40 g [IQR = 30-40]). Variability was observed in portion size and/or energy content for dairy (60 g [IQR = 25-93]), protein (72 kcal [IQR = 44-106]) and starchy (41 g/71 kcal [IQR = 25-80/56-106]) food groups. The range in size of an average eating occasion was large (90-292 g). This review identifies resources that could help caregivers to choose appropriate portion sizes for preschool-aged children but also highlights how future resources could be improved.
Highlights
Childhood obesity prevention is a current worldwide public health priority.[1]
To manage overall energy intake, it is important to consider the combined effect of altering portion sizes of different foods because eating occasions typically represent a mixture of many foods rather than a single one
A study by Syrad et al.[13] found that in a United Kingdom (UK) twin birth cohort, a small (10 kcal) increase in meal size at 21 months was associated with a 4% faster growth rate above the average, demonstrating that increasing meal size was associated with more rapid weight gain
Summary
Childhood obesity prevention is a current worldwide public health priority.[1]. Data collected in 2018/2019 show that 22.6% of 4- to 5-yearold children in England were classified as overweight or obese, with similar rates observed in the rest of the United Kingdom.[2]. Research suggests that infants (0–1 years) are able to selfregulate their energy intake.[4] this self-regulation mechanism seems to diminish with age,[4, 5] making young children increasingly susceptible to factors such as parent feeding practices or environmental cues, which may result in overconsumption. Longitudinal evidence has shown that larger total meal sizes consumed at 21 months were associated with faster growth rate above the average, from 2 to 5 years, suggesting that meal size (resulting from the combination of many foods) may be a critical driver of weight gain.[13]
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