In Sweden, milk and milk products are important sources of daily energy intake but the role of milk with preschool lunch meals has been debated frequently and water is often alternatively given today. We studied the effects of milk or water on lunch energy intake. Water or milk alternatively was served in a controlled, within-subject design on 12 occasions to 36 children aged 4–6 years, and energy intake was analysed at an individual level in three typical preschool lunches with a varying degree of preference among the children. When milk was given with the meals, a mean additional energy intake of 17% (p<0·0001) was found. The pattern was similar among boys and girls and irrespective of the lunch dish served. However, for the least preferred dish (fish with potatoes) milk helped to increase the energy intake by 26%. Physical activity measured as MET units (energy expenditure/body weight), atmosphere at the table as registered by a three-graded scale, and meal duration did not differ with meals or milk/water. Milk with preschool lunch meals seems to be a significant source of energy to achieve nutritional goals for this group of children.
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