Both increases and decreases in energy density lead to sustained changes in preschool children's energy intake over 5 days

To investigate preschool children's ability to self-regulate their energy intake, we assessed their response to increases or decreases in dietary energy density (ED) over 5 consecutive days, a period likely long enough for compensatory behavior. Using a crossover design, over 3 periods we served the same 5 daily menus to 49 children aged 3–5 y in their childcare centers. During each 5-day period, 3 main dishes and 1 snack per day were systematically varied in ED, from baseline ED to either higher ED (increased by 20%) or lower ED (decreased by 20%). All of the served items were weighed to determine individual intakes. Modifying the ED of 4 dishes per day had a significant and sustained effect on preschool children's daily energy intake across 5 days. In the baseline condition, children's intakes were similar to daily energy needs (98 ± 2%), but serving higher-ED foods increased energy intake by 84 ± 16 kcal/d (to 105 ± 2% of needs) and serving lower-ED foods decreased energy intake by 72 ± 17 kcal/d (to 89 ± 2% of needs; both P