Savage 2012

Methods	Study design: Randomised controlled trial Funding: Not reported
Participants	Description: Children aged 3 to 5 years attending full‐day childcare at the Child Development Laboratory located at The Pennsylvania State University N (Randomised): 21 children Age: Mean = 4.3 years % Female: 59% SES and ethnicity: “most of the families (60%) reported combined family incomes of US>$50,000.” Inclusion/exclusion criteria: “Exclusion criteria were the presence of food intolerance to study foods, chronic illness affecting food intake, consuming <22 g of the entree (<10% of the 220‐g entree portion), dislike of the main entree, uncooperative behavior during lunch, non‐English speaking, or extended absences.” Recruitment: Not specified Recruitment rate: Unknown Region: Pennsylvania (USA)
Interventions	Number of experimental conditions: 6 Number of participants (analysed): Overall = 17 (not specified by group) Description of intervention: “Children were served a series of 6 lunches in a random order, once per week, which varied only in entrée portion size (entree portion size order: 100, 160, 220, 280, 320, and 400 g). Children were served lunch on the same day of the week at their regularly scheduled time in an eating laboratory dining room facility near their classroom.” “The menu at all lunches included the portion‐manipulated macaroni and cheese entree and fixed portions of 2% milk and other foods served with the entree (eg, green beans with butter, whole‐wheat roll, and unsweetened applesauce).” Duration: 6 days Number of contacts: 6 (1 lunch per day) Setting: Preschool Modality: Face‐to‐face Interventionist: Research staff Integrity: No information provided Date of study: 2007 Description of control: N/A
Outcomes	Outcome relating to children's fruit and vegetable consumption: Child’s consumption of fruit and vegetable for different entree portion sizes (grams). “Food and milk weights were recorded before and after consumption to the nearest 0.1 g by using digital scales (Mettler‐Toledo PR5001 and Mettler‐Toledo XS4001S; Mettler‐Toledo Inc). The amount of each food item consumed (g) was determined by subtracting postmeal weights from premeal weights.” Outcome relating to absolute costs/cost effectiveness of interventions: Not reported Outcome relating to reported adverse events: Not reported Length of follow‐up from baseline: 6 days Length of follow‐up post‐intervention: Immediately Subgroup analyses: None Loss to follow‐up: Overall = 19% (not specified by group) Analysis: Unknown if sample size calculations performed.
Notes
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Randomly allocated but the random sequence generation procedure is not described
Allocation concealment (selection bias)	Unclear risk	There is no information provided about allocation concealment and therefore it is unclear if allocation was concealed
Blinding of participants and personnel (performance bias) All outcomes	Low risk	Food and milk intake: Objective measure of child’s food intake and unlikely to be influenced by performance bias
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Food and milk intake (weighed before and after consumption): Objective measure of child’s food intake because food was weighed before and after consumption. Low risk of detection bias
Incomplete outcome data (attrition bias) All outcomes	Low risk	There is no reported attrition. Data are reported for all of the 17 children who met predetermined inclusion criteria
Selective reporting (reporting bias)	Unclear risk	There is no study protocol therefore it is unclear if there was selective outcome reporting
Other bias	Low risk	Contamination, baseline imbalance, & other bias that could threaten the internal validity are unlikely to be an issue