An increase in energy intake often occurs at weaning and this may depend on the current practice of offering energy-dense foods ad libitum. In two-year-old lean infants suffering from chronic non-specific diarrhoea (CNSD), the offering of food was evaluated by caregivers at every meal on the basis of food need expressions and non-starchy vegetable acceptance, taking into account the maintenance of good temper and normal activity between meals. The purpose was to avoid diarrhoea recurrence. This form of regulation was continued in a prospective, controlled, randomized investigation to explore: (i) familial pre-determination of growth and (ii) the existence of an 'unnecessary' fraction of energy intake, i.e. a fraction which may habitually be excluded while still maintaining the same normal intermeal behaviour, intellectual and physical achievements, growth, skinfold thicknesses and blood parameters. Seven-day intake home diaries and clinical assessments were performed every 6 to 12 months. Growth records were investigated in siblings. Eighty-two of 91 experimental subjects and 32 of 41 randomized ones in the control group were followed for up to four years. The control group maintained a significantly higher (15-30%) energy intake than the experimental children, without any fattening or growth acceleration, or any improved results in inter-meal behaviour, intellectual and physical achievements or blood parameters for four years. The normal median weight was reached in the experimental and control children in the sixth year of life and in the siblings in the fourth year of life.(ABSTRACT TRUNCATED AT 250 WORDS)

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