Food portion patterns and trends among U.S. children and the relationship to total eating occasion size, 1977-2006.

Food and beverage portion sizes are related to childhood obesity. We examined trends in food portion sizes and the association with total meal sizes among U.S. children. We selected children 2- to 18-y-old (n = 31,337) from 4 nationally representative surveys of food intake between 1977-1978 and 2003-2006. We assessed portion sizes (kcal and g) of selected key foods (soft/fruit drinks, salty snacks, desserts, French fries, burgers, pizzas, Mexican fast foods, and hot dogs), the total energy from eating occasions that included key foods, and portion sizes of the selected key foods by source (stores, restaurants, and fast-food locations). These foods represented over one-third of children's energy intake in 2003-2006. Portion sizes increased significantly over the 30-y period and increases in pizza were particularly pronounced in the last decade [+176 kcal (736 kJ). Energy from eating occasions including pizzas and soft drinks increased, as did the proportion of energy from these foods in an eating occasion. Hamburgers and cheeseburgers increased in portion size and eating occasion size, but the proportion of these foods in the total eating occasions did not increase. Portion sizes of other key foods increased, although the total energy from eating events that included them remained constant (e.g. Mexican fast-foods, French fries, fruit drinks) or decreased (e.g. salty snacks, desserts). Portion sizes increased across all food sources (stores, restaurants, and fast foods) for soft drinks and pizzas but only at fast-food locations for French fries. Portion sizes continue to grow for selected foods. Fast-food chains appear to be linked with less healthful portion size increases for selected foods.