Here is a study that gives us all something to think about, especially as we are trying to help our young children develop healthy eating habits.

MONDAY, April 8 (HealthDay News) — Small children who are given large plates and then allowed to serve themselves take more food and consume more calories, new research finds.

The study used 41 first-graders in a Philadelphia elementary school to test whether adult research on dishware size and food intake also holds true for children.

“We found that children served themselves about 90 more calories when they used the large plate at lunch [compared to a small plate],” said Katherine DiSantis, assistant professor of community and global public health at Arcadia University in Glenside, Penn.

It turns out, however, that the children had a case of eyes-bigger-than-stomach. “They ate approximately half of every additional calorie they served themselves,” DiSantis said.

The study, funded by the U.S. Department of Agriculture, was published online April 8 in the journal Pediatrics and will be in the May print issue of the journal.

Obesity in children is a growing problem in the United States. About 17 percent of children aged 2 to 19 are obese, according to the U.S. Centers for Disease Control and Prevention.

“In adults, the size of the dinner plate is known to affect how much they put on it and how much they eat,” DiSantis said. Other research has found that kids eat more food when they are served larger portions. But it was not known, DiSantis said, “Whether the use of larger, adult-sized plates would make kids take and eat more food if they served themselves.”

The researchers invited the 41 first graders from two different classrooms at a private elementary school to eat lunch, using a small child’s plate first and then an adult-sized one. The children had their choice of an entree and side dishes (pasta with meat sauce, chicken nuggets, mixed vegetables and applesauce). They all got fixed portions of milk and bread with each meal.

The researchers weighed the portions before and after the children ate and calculated their caloric intake.

“The two factors — plate size and being allowed to take their own food — seemed to work together, DiSantis said. “Overall, the adult-sized dishware by itself did not promote eating more.”

The child’s body-mass index (a measure of body fat based on height and weight) didn’t seem to predict who would take more food, the researchers found.

It was the child’s liking for the food that predicted what they would serve themselves. Those who liked the entree helped themselves to about 104 calories more at the meal.

DiSantis said, “Children look to their environment for some direction when put in the position of making decisions about how much food to serve themselves.”

“In the study, the differences in calories were not large,” she acknowledged. “But if this went on on a daily basis, it could contribute to the child’s overall energy intake and their weight status,” she said. “Using smaller plates might give children guidance on portion sizes, she added.

A nutrition expert who reviewed the study downplayed the role of plate size, while not dismissing it entirely.

“In the end, it’s the portion that’s served rather than the plate size — and whether or not the child likes the food — that influences how much they eat and how much they serve themselves,” said Marjorie Freeman, associate professor of nutrition, food science and packaging at San Jose State University in California. In her own research, she has found that as portion size increases, so does the amount you eat.

Freeman suggested that parents follow the U.S. Department of Agriculture’s recommendations, which suggest filling half the plate with fruits and vegetables.

Parents also can choose plate sizes for serving their children based on what will be on the plate. “For foods you want them to eat a lot of, such as fruits and vegetables, I’d put it on larger plates,” she said.

The fried chicken nuggets, she added, could be served on a small plate.

The study authors noted that the kids in the experiment served themselves more fruit on their large plates, but not more vegetables.

More information

To learn more about how to eat healthy foods, visit ChooseMyPlate.gov.

At a recent meeting of the Obesity Society Jason Block, MD, of Harvard Medical School and fellow researchers reported that parents often underestimate the calories their school-age kids are consuming when they eat large meals at fast food restaurants.

According to the study, the average meal purchased  in four New England cities contained 733 calories, and 21% contained more than 1,000 calories, But the parents estimated an average of only 562 calories per meal, with 72% underestimating the actual content. “There was an association between larger meals and larger underestimations, which may hold some promise for menu labeling,” Dr. Block said. He noted that the Affordable Care Act (ACA) mandates that restaurants with 20 or more locations nationwide post calorie information on their menus.

The researchers found that only 15% of parents saw nutritional information in the restaurants and fewer still (4%) used that information when ordering. “So they may not use it even if it’s more accessible,” Block stated.

Last year at the society’s annual meeting, Dr Block reported that 80% of adolescents in Boston, Springfield, Mass., Providence, R.I., and Hartford, Conn., underestimated the amount of calories their fast food meals contained and 86% did not notice any nutritional information in the restaurants.

In the current study, Block and his colleagues visited 10 restaurants in each of the four cities… three McDonald’s, three Burger King, two Subway, one KFC, and one Wendy’s. Each restaurant was visited six times at dinnertime.

Those participating in the study included parents or legal guardians of children and teens, ages 3 to 15 (mean age 7.9). The analysis included 330 families, representing 45% of those who were approached.

Most of the children (57%) were overweight or obese. The sample was ethnically diverse — 33% black, 30% Hispanic, 19% white, 3% Asian, and 15% other or multiracial.

The researchers collected receipts when the parents left the restaurants and administered a short survey about the calorie content of the meal and awareness and use of the nutritional information. The actual calorie content of the meals was calculated using the receipts and information on the restaurants’ websites.

Many of the parents purchased large meals for their children and most underestimated the calorie content. Nearly one-quarter (24%) underestimated the calorie count by at least 500.

Those who underestimated the daily requirement tended to also underestimate the calories in a meal, a finding that “supports an anchoring statement on menus,” Block said. The federal regulations require that, in addition to calorie information, menus must include an anchoring statement describing the typical daily calorie requirement.

The study was funded by the National Heart, Lung, and Blood Institute and by a Robert Wood Johnson Foundation Health and Society Scholars Seed Grant.

Source: The Obesity Society

The results of a recent comparison study of four diets suggest that it doesn’t matter where the calories come from, as long as dieters reduce their daily intake of calories. That is how dieters ultimately lose weight.

Dr. George Bray, who worked on the new study, said earlier research had found certain diets — in particular, those with very little carbohydrate — work better than others. Diet books also often guide consumers to adopt a particular type of meal plan, such as low-fat or low-carb-high-protein diets.

Since there hasn’t been consensus among scientists, Dr. Bray of Pennington Biomedical Research Center in Baton Rouge, Louisiana, and his colleagues randomly assigned several hundred overweight or obese people to one of four diets: average protein, low fat and higher carbs; high protein, low fat, and higher carbs; average protein, high fat and lower carbs; or high protein, high fat and lower carbs.

Each of the diets was designed to eliminate 750 calories a day.

After six months and again at two years after the diets started, the researchers checked in on people’s weight, fat mass and lean mass.

At six months, people had lost more than nine pounds of fat and close to five pounds of lean mass, but some of this was regained by the two-year mark.

People were able to maintain a weight loss of more than eight pounds after two years. Included in that was a nearly three-pound loss of abdominal fat, a reduction of more than seven percent.

The team found no differences in weight loss or fat reductions between the diets. It  all comes down to calories.

Dr. Bray recommended a diet developed by some of his co-authors, and which is also endorsed by the National Institutes of Health, called the DASH plan, or Dietary Approaches to Stop Hypertension.

“We would encourage patients to follow this diet modified as they and their Health Care Provider chose to emphasize macronutrient changes that they thought might work best for them,” Bray said.

SOURCE: American Journal of Clinical Nutrition, online January 18, 2012.