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Energy intakes of children after preloads: adjustment, not compensation^1,2,3

¹ From the Bute Medical School, University of St Andrews, St Andrews, United Kingdom (JEC); the Biomedical Research Centre (CNAP) and the Centre for Public Health Nutrition Research (WW and IM), Ninewells Hospital and Medical School, University of Dundee, Dundee, United Kingdom; the MRC Human Nutrition Unit, Cambridge, United Kingdom (CB-S); the Chelsea School, University of Brighton, Brighton, United Kingdom (PW); and the School of Psychology, University of Liverpool, Liverpool, United Kingdom (DJW and MMH)

Background: Young children accurately compensate for energy-dense preloads consumed before test meals. The accuracy of compensation seems to deteriorate as a function of age.

Objective: The hypothesis that accurate energy compensation varies by age, body mass index, and individual characteristics of children and their mothers was tested.

Design: Energy intake (EI) from a test meal was measured in 74 children aged 6–9 y 90 min after the ingestion of no-energy (NE), low-energy (LE), or high-energy (HE) preload snacks. The NE preload consisted of 250 mL water, the LE preload consisted of a 56-g muffin + a 250-mL orange drink (783 kJ), and the HE preload consisted of a 56-g muffin + a 250-mL orange drink (1628 kJ).

Results: A significant dose-related reduction in EI was found after the preloads; younger children adjusted more effectively than did older children, although total EI (including preload energy) indicated that the adjustment was not accurate. The compensation index (COMPX) differed by preload and age group; COMPX scores were higher between the NE and LE preloads (younger children: 44.4 ± 9.3%; older children: 57.0 ± 11.6%) than between the NE and HE preloads (39.6 ± 4.9%; 31.3 ± 6.2%) and the LE and HE preloads (35.2 ± 7.8%; 7.4 ± 9.8%). This finding indicates a more consistent response across preloads and a greater sensitivity to energy load by younger than by older children. High interindividual variation and low intraindividual variation in COMPX was found. The tendency to over- or undereat in response to the preloads (deviation from perfect) correlated directly and positively with maternal concerns about child overweight, not with actual BMI.

Conclusions: The children adjusted their EIs in response to different preloads, and the younger children did so more effectively than did the older children. Poor short-term energy compensation may constitute a behavioral marker for positive energy balance.

Key Words: Children • eating behavior • energy compensation • food intake • child overweight

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