Large Portion Sizes Research Articles

Revision of food-based dietary guidelines for Ireland, Phase 1: evaluation of Ireland's food guide

To evaluate Ireland's food-based dietary guidelines and highlight priorities for revision. Evaluation with stakeholder input. Energy and nutrient intake goals most appropriate for Ireland were determined. Advice from Ireland's food guide was translated into 4 d food intake patterns representing age and gender groups from 5 to 51+ years. Nutritional content of the food patterns was compared with identified goals and appropriateness of food advice was noted. Feedback from stakeholders was obtained on portion size of foods within the Bread, Cereal and Potato group and of portion descriptors for meat and cereal foods. Government agency/community. General population aged 5+ years, dietitians/nutritionists (n 44) and 1011 consumers. Goals were identified for energy, macronutrients, fibre, Fe, Ca and vitamin D. Goals not achieved by the food patterns included energy, total fat, saturated fat, fibre and vitamin D. Energy content of food portions within the Bread, Cereal and Potato group varied widely, yet advice indicated they were equivalent. Dietitians/nutritionists agreed with the majority of consumers surveyed (74 %, n 745) that larger portion sizes within the Bread, Cereal and Potato group were more meaningful. 'Palm of hand' as a descriptor for meat portions and a '200 ml disposable cup' for quantifying cereal foods were preferred. Revision of the guidelines requires specific guidance on energy and vitamin D intakes, and comprehensive advice on how to reduce fat and saturated fat and increase fibre intakes. Advice should use portion descriptors favoured by consumers and enlarged portion sizes for breads, cereals and potatoes that are equivalent in terms of energy.

View the label before you view the movie: A field experiment into the impact of Portion size and Guideline Daily Amounts labelling on soft drinks in cinemas

BackgroundLarge soft drink sizes increase consumption, and thereby contribute to obesity. Portion size labelling may help consumers to select more appropriate food portions. This study aimed to assess the effectiveness of portion size and caloric Guidelines for Daily Amounts (GDA) labelling on consumers' portion size choices and consumption of regular soft drinks.MethodsA field experiment that took place on two subsequent evenings in a Dutch cinema. Participants (n = 101) were asked to select one of five different portion sizes of a soft drink. Consumers were provided with either portion size and caloric GDA labelling (experimental condition) or with millilitre information (control condition).ResultsLabelling neither stimulated participants to choose small portion sizes (OR = .75, p = .61, CI: .25 - 2.25), nor did labelling dissuade participants to choose large portion sizes (OR = .51, p = .36, CI: .12 - 2.15).ConclusionsPortion size and caloric GDA labelling were found to have no effect on soft drink intake. Further research among a larger group of participants combined with pricing strategies is required. The results of this study are relevant for the current public health debate on food labelling.

Role of Dietary Factors and Food Habits in the Development of Childhood Obesity: A Commentary by the ESPGHAN Committee on Nutrition

This Comment by the Committee on Nutrition of the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition aims to provide a summary of the role of nutrition-related factors on obesity prevention in children ages 2 to 18 years. This Comment emphasizes that dietary interventions should be incorporated into a multidisciplinary strategy for obesity prevention. No single nutrient has been unequivocally associated with the development of obesity. Methodological limitations in study design and the complex nature of obesity must be taken into account when interpreting the association with reported dietary factors. Energy intake should be individually determined, taking into account energy expenditure and growth. Preferential intake of slowly absorbed carbohydrates and limiting the ingestion of rapidly absorbed carbohydrates and simple sugars should be promoted. No specific recommendations for macronutrient intakes to prevent obesity can be made. Plant foods can be used as the main food contributors to a well-balanced diet with adequate monitoring of nutrient intake. Plain water should be promoted as the main source of fluids for children instead of sugar-sweetened beverages. Children should eat at least 4 meals, including breakfast, every day. Regular family meals should be encouraged. Regular consumption of fast food with large portion sizes and high energy density should be avoided. Healthy food options should be promoted for snacking. Food portion sizes should be appropriate for age and body size. Nutrition and lifestyle education aimed at the prevention of obesity should be included in the routine care of children by health care professionals.

Impact of Portion Size and Energy Density on Snack Intake in Preschool-Aged Children

The influence of dietary environmental factors on child weight status may be important in the battle against childhood obesity. Portion size and energy density are factors shown to impact entrée energy intake in children. However, the influence of these factors on child snack energy intake has not been studied. Thus, the aim of this study was to investigate the impact of portion size on intake of a lower energy-dense and higher energy-dense snack in preschool-aged children. A 2×2 crossover design (within-subject factors of portion size and energy density) was conducted on Wednesdays in a preschool setting on the University of Tennessee campus from October 2008 to November 2008. Seventeen children had complete data (age 3.8±0.6 years; 10 of 17 were female; 14 of 17 were white). Foods were applesauce (lower energy dense=0.43 kcal/g) and chocolate pudding (higher energy dense=1.19 kcal/g), and portion sizes were 150 g (small) and 300 g (large). Measures included anthropometrics, hunger, liking of foods, and caretakers' child-feeding practices using validated instruments. Mixed factorial analyses of covariance, with order controlled, analyzed gram and energy snack intake across conditions. There was no significant main effect of energy density on snack intake, but the main effect of portion size on snack intake (small portion size 84.2±30.8 kcal, large portion size 99.0±52.5 kcal; P<0.05) was significant. Results indicate increased energy intake when snacks are offered in larger portion size, regardless of energy density. Snack portion size may be an environmental strategy that can reduce excessive energy intake in children.

Size matters: exploring the links between food portion sizes and diet quality in Irish children

Food portions have increased over the last 20 years. This has been shown to be true for the foods we eat at home, those consumed at restaurants and fast-food outlets, and for foods sold in packages. Along with this increase in food portion sizes has been an increase in both child and adult obesity, leading to the obvious question: could larger food portion sizes be contributing to the obesity epidemic? The World Health Organisation (WHO) has cited large portion sizes as a ‘possible’ dietary risk factor for obesity, which according to their definition means that ‘more trials are needed to support the tentative associations’. Their caution is based on the fact that the evidence comes mainly from cross-sectional studies, which typically include a large number of individuals but are essentially observational, and therefore cannot conclude that the relationship between large portion sizes and obesity is a causative one. The WHO ...

Portion Size Labeling and Intended Soft Drink Consumption: The Impact of Labeling Format and Size Portfolio

Objective To assess what portion size labeling format is most promising in helping consumers selecting appropriate soft drink sizes, and whether labeling impact depends on the size portfolio. Methods An experimental study was conducted in fast-food restaurants in which 2 labeling formats (ie, reference portion size and small/medium/large labels) were compared to a control condition, and 2 size ranges were assessed. The main outcome variable was participants' intended soft drink size choice. Stimulus material was presented through photographs. Results There was a statistical trend for reference portion size labeling increasing the likelihood to choose small sizes (n = 158, odds ratio = 2.55, P = .06, confidence interval: 0.84-7.70). Conclusions and Implications Reference portion size labeling is potentially most promising in reducing large portion size preferences. More research assessing the effectiveness of reference portion size labeling (combined with pricing strategies) on actual choices and consumption behavior in a realistic setting is recommended.

Obesity Perceptions among Chinese Americans

The objective of this qualitative research was to examine the interface of traditional Chinese and American values related to perceptions of obesity among Chinese Americans. Semi-structured interviews were conducted with forty Chinese American adults (twenty-four females; sixteen males) in the New York City metropolitan area. The interview protocol was derived from tenets of major social psychological theories. Common themes were identified, coded, and compared using NVivo computer software. The participants described pressures to overeat due to traditional Chinese influences, along with the plethora of mainstream American fast food characterized by large portion sizes. Social norms related to desirable body weight and gender effects were evident. Nutrition professionals need to be culturally competent, and understand the traditional values and beliefs of Chinese Americans regarding obesity prevention. Public policy and support for healthier social environments are mandated to encourage individuals to select foods with a nutritional value conducive to weight management.

Are Children the Future of Type 2 Diabetes Prevention?

The lifetime risk of type 2 diabetes is now more than one in three in the general U.S. population, and one in six adolescents is now obese, suggesting that prevention should start in childhood.1,2 Many consider diabetes and obesity to be “common-source” epidemics that are rooted in our culture, as evidenced by national trends toward larger portion sizes and more meals built around calorically dense fast food, sugar-sweetened drinks, and sedentary behavior.3,4 Fighting such a powerful wave with purely clinical and adult-based approaches to prevention may seem like pasting a small bandage on a gaping wound. Rather than . . .

Assessment of typical food portion sizes consumed among Australian adults

AbstractAim: To document the typical portion sizes of commonly consumed foods as reported by adults in the 1995 National Nutrition Survey, and to compare these data with existing information on serving sizes used in Australia.Methods: Portion sizes of foods were defined as total amounts of food consumed per eating occasion, using estimated food portion weight data from the 1995 National Nutrition Survey. Age‐ and sex‐specific median (typical) and interquartile ranges were produced for the most commonly consumed foods for Australian adults. These were compared with other data on weighed food records, sample servings as used in the Australian Guide to Healthy Eating and ‘unspecified’ serves as used in nutritional analysis software.Results: Typical portion sizes for many commonly consumed foods varied significantly by age and sex of the consumer, with larger portion sizes being consumed by men, and by younger adults. Portion size differences between sex were not consistent across food types; therefore, a fixed ratio cannot be applied to all food types. Typical portion sizes estimated from the National Nutrition Survey were similar to median portion sizes obtained from weighed food records for many foods but were not similar to the generic sample servings and ‘unspecified’ serves.Conclusions: The significant age and sex differences in portion sizes consumed indicate the need for age‐ and sex‐specific portion sizes in dietary analysis. Portion size research has particular relevance to the current revision of the dietary guidelines, core food groups and the development of a new food guide in Australia.

Small, medium, large or supersize: trends in food portion sizes in The Netherlands

Larger food portion sizes lead to increased energy intake levels and might contribute to the current obesity epidemic. Only a very limited number of studies are available on the actual development of food portion sizes during past decades. The present study aims to reveal trends in portion sizes of some high-energy-dense food products during recent decades in The Netherlands. The data were collected from manufacturers and from information found in professional journals, marketing and advertising materials, and on manufacturers' websites. A number of trends in food portion sizes were observed. Larger sizes have been added to the portion size portfolio. The portion sizes of a number of products have also increased since their introduction, although this did not apply to all the products included. Finally, multi-packs have been introduced and the number of products within a multi-pack has also increased. A trend towards larger portion sizes was observed, which is relevant to the public health debate regarding the prevention of overweight and obesity. It is recommended that developments in food portion sizes continue to be monitored over the coming years, and the effects of the newly introduced portion sizes on food intake be studied.

How Many Calories Are on Our Plate? Expected Fullness, Not Liking, Determines Meal‐size Selection

The availability of highly palatable food is thought to stimulate the selection of larger meals (leading to weight gain and obesity). In this article, we explore aspects of this proposition. Specifically, we scrutinize two basic assumptions: (i) palatable energy-dense foods are more rewarding (desired), and (ii) these palatable foods are selected in relatively larger portions. In combination with palatability, we also consider the relative role for "expected satiation"-the extent to which a food is expected to deliver satiation. A total of 17 commonly consumed foods were assessed by 28 normal-weight participants at lunchtime. Critically, our measure of food reward and expected satiation involves comparisons between foods based on equicaloric portions. When assessed in this way, we find that food reward and ideal portion sizes (in kcal) are both closely associated with expected satiation, but not with "expected liking." Low expected satiation (not expected liking) predicts the selection of large portion sizes (in kcal) and foods with this characteristic tend to be more energy dense and are regarded as less (not more) rewarding (when compared calorie for calorie). Together, these findings challenge the role of palatability in meal-size selection and they highlight the importance of expected satiation, a "nonaffective" component of food reward.

Portion size: a qualitative study of consumers' attitudes toward point-of-purchase interventions aimed at portion size

This qualitative study assessed consumers' opinions of food portion sizes and their attitudes toward portion-size interventions located in various point-of-purchase settings targeting overweight and obese people. Eight semi-structured focus group discussions were conducted with 49 participants. Constructs from the diffusion of innovations theory were included in the interview guide. Each focus group was recorded and transcribed verbatim. Data were coded and analyzed with Atlas.ti 5.2 using the framework approach. Results showed that many participants thought that portion sizes of various products have increased during the past decades and are larger than acceptable. The majority also indicated that value for money is important when purchasing and that large portion sizes offer more value for money than small portion sizes. Furthermore, many experienced difficulties with self-regulating the consumption of large portion sizes. Among the portion-size interventions that were discussed, participants had most positive attitudes toward a larger availability of portion sizes and pricing strategies, followed by serving-size labeling. In general, reducing package serving sizes as an intervention strategy to control food intake met resistance. The study concludes that consumers consider interventions consisting of a larger variety of available portion sizes, pricing strategies and serving-size labeling as most acceptable to implement.

Value for money or making the healthy choice: the impact of proportional pricing on consumers’ portion size choices

Large food portion sizes are determinants of a high caloric intake, especially if they have been made attractive through value size pricing (i.e. lower unit prices for large than for small portion sizes). The purpose of the two questionnaire studies that are reported in this article was to assess the impact of proportional pricing (i.e. removing beneficial prices for large sizes) on people's portion size choices of high caloric food and drink items. Both studies employed an experimental design with a proportional pricing condition and a value size pricing condition. Study 1 was conducted in a fast food restaurant (N = 150) and study 2 in a worksite cafeteria (N = 141). Three different food products (i.e. soft drink, chicken nuggets in study 1 and a hot meal in study 2) with corresponding prices were displayed on pictures in the questionnaire. Outcome measures were consumers' intended portion size choices. No main effects of pricing were found. However, confronted with proportional pricing a trend was found for overweight fast food restaurant visitors being more likely to choose small portion sizes of chicken nuggets (OR = 4.31, P = 0.07) and less likely to choose large soft drink sizes (OR = 0.07, P = 0.04). Among a general public, proportional pricing did not reduce consumers' size choices. However, pricing strategies can help overweight and obese consumers selecting appropriate portion sizes of soft drink and high caloric snacks. More research in realistic settings with actual behaviour as outcome measure is required.

Univariate and default standard unit biases in estimation of body weight and caloric content.

College students estimated the weight of adult women from either photographs or a live presentation by a set of models and estimated the calories in 1 of 2 actual meals. The 2 meals had the same items, but 1 had larger portion sizes than the other. The results suggest: (a) Judgments are biased toward transforming the example in question to the size and/or properties of a "standard" unit. For estimates of body weight, students assigned weights assuming a standard height, even though height information was provided in the photographs or directly present with live models. (b) There is an inclination to focus on 1 aspect or dimension of the stimulus (e.g., for female figures, their width, for meals the identity of the components as opposed to their size) and either devalue or completely ignore another parameter critical for accurate judgment (height, for the case of body weight estimations). That is, students defaulted to a normative unit size and thus treated the stimulus as a representative, categorical, and unvarying example, and focused on only 1 dimension (univariate bias) in making judgments. (PsycINFO Database Record (c) 2009 APA, all rights reserved).

Influence of Larger Portion Sizes on the Diet of Overweight Children and Adolescents

Influence of Larger Portion Sizes on the Diet of Overweight Children and Adolescents

Estimating everyday portion size using a ‘method of constant stimuli’: In a student sample, portion size is predicted by gender, dietary behaviour, and hunger, but not BMI

This paper (i) explores the proposition that body weight is associated with large portion sizes and (ii) introduces a new technique for measuring everyday portion size. In our paradigm, the participant is shown a picture of a food portion and is asked to indicate whether it is larger or smaller than their usual portion. After responding to a range of different portions an estimate of everyday portion size is calculated using probit analysis. Importantly, this estimate is likely to be robust because it is based on many responses. First-year undergraduate students ( N = 151) completed our procedure for 12 commonly consumed foods. As expected, portion sizes were predicted by gender and by a measure of dieting and dietary restraint. Furthermore, consistent with reports of hungry supermarket shoppers, portion-size estimates tended to be higher in hungry individuals. However, we found no evidence for a relationship between BMI and portion size in any of the test foods. We consider reasons why this finding should be anticipated. In particular, we suggest that the difference in total energy expenditure of individuals with a higher and lower BMI is too small to be detected as a concomitant difference in portion size (at least in our sample).

Preventing or Improving Obesity by Addressing Specific Eating Patterns

The problem of obesity and overweight is an epidemic in the United States. Weight is a product of energy balance: energy intake versus energy expenditure. The purpose of this review is to identify adult eating behaviors that are known to strongly affect the energy intake side of the energy balance and that may be readily amenable to prevention and intervention efforts in primary care. Restaurant and fast food consumption, large portion sizes, and consumption of beverages with sugar added increase energy intake and are highly associated with weight gain and obesity. Conversely, consumption of low energy dense food, ie, fruits and vegetables, and routine healthy breakfast consumption can help to maintain or lose weight. These distinct behaviors represent concrete negative and positive eating patterns on which primary care providers can focus when counseling overweight and obese patients. They also represent behavioral targets for designing and testing clinical interventions.

Acceptability by a low income audience of a low cost two week cycle menu that meets the food recommendations of the 2005 Dietary Guidelines for Americans

The purpose of this study was to plan a low‐cost two week cycle menu with foods/recipes tailored to tastes of Southeast Louisiana that met the 2005 Dietary Guidelines (DGA) for a family of four (male, female, two children) and to test its acceptability by a regional low‐income audience. Menus, costing an average of $616/week (mean price from 29 regional grocery stores), met the energy and food recommendations of the DGA, but differed substantially from the usual intake of this population since they included more whole grains, beans, fruit, vegetables, and dairy than are commonly consumed by this population. To test acceptability, two groups of low‐income individuals were interviewed. Group 1 (n=8; 100% female; 63% black) and group 2 (n=12; 75% female; 100% black) were questioned about acceptability of and barriers to consuming these menus. Group 1 was older (38.6±7.4y [SD]) and had more children (4.25±2.4) than Group 2 (23.8±10.8, 0.25±0.62) (p&lt;0.001 for both); unlike Group 2, Group 1 had nutrition education through EFNEP and a better understanding of nutrition. They stated that they liked fruit and vegetables more, and found the menus feasible and much more acceptable than Group 2. Group 2 wanted to substitute more nutrient dense foods into the menus. Both groups generally wanted larger portion sizes and fewer legumes. Taste and lactose intolerance were the principal barriers to acceptability. Support: ERS Small Grant.

Nutrition transition and its relationship to the development of obesity and related chronic diseases

The prevalence of overweight and obesity has also increased substantially in the nutritional transition countries, and the health burden of obesity-related complications is growing. The introduction of fast-food chains and Westernized dietary habits providing meals with fast-food characteristics seems to be a marker of the increasing prevalence of obesity. The mechanisms involved are probably that the supply of foods is characterized by large portion sizes with a high energy density, and sugar-rich soft drinks. The high energy density of foods is partly brought about by a high dietary fat content, and it has been shown that even in a Chinese population the increase from about 15% to 20% in the proportion of calories from fat is sufficient to explain some weight gain in the population. In addition, fast food from major chains in most countries still contains unacceptably high levels of industrially produced trans fatty acids that have powerful biological effects, and contribute to type 2 diabetes and coronary artery disease. New evidence also suggests that a high intake of trans fat may produce abdominal obesity, an important factor in the metabolic syndrome, type 2 diabetes and cardiovascular disease. The optimal diet for the prevention of weight gain, obesity, metabolic syndrome and type 2 diabetes is fat-reduced, without any industrially produced trans fatty acids, fibre-rich, high in low energy density carbohydrates (fruit, vegetables and whole grain products) and with a restricted intake of energy-containing drinks.

Portion size effects on daily energy intake in low-income Hispanic and African American children and their mothers

Portion size influences children's energy intakes at meals, but effects on daily intake are unknown. Effects of large portions on daily energy intake were tested in 5-y-old Hispanic and African American children from low-income families. Maternal food intake data were collected to evaluate familial susceptibility to portion size. A within-subjects experimental design with reference and large portion sizes was used in a study of 59 low-income Hispanic and African American preschool-aged children and their mothers. The portion size of 3 entrées (lunch, dinner, and breakfast) and an afternoon snack served during a 24-h period were of a reference size in one condition and doubled in the other condition. Portion sizes of other foods and beverages did not vary across conditions. Weighed food intake, anthropometric measures, and self-reported data were obtained. Doubling the portion size of several entrées and a snack served during a 24-h period increased energy intake from those foods by 23% (180 kcal) among children (P < 0.0001) and by 21% (270 kcal) among mothers (P < 0.0001). Child and maternal energy intakes from other foods for which portion size was not altered did not differ across conditions. Consequently, total energy intakes in the large-portion condition were 12% (P < 0.001) and 6% (P < 0.01) higher in children and mothers, respectively, than in the reference condition. Child and maternal intakes of the portion-manipulated foods were not correlated. Large portions may contribute to obesigenic dietary environments by promoting excess daily intakes among Hispanic and African American children.