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PubMed2004

Energy density and portion size: their independent and combined effects on energy intake.

The energy density (kcal/g) and the portion size (g) of foods have been identified as two properties of foods that can modulate energy intake. Recent studies have shown that when either the energy density or the portion size of foods is increased, energy intake increases. Within a meal, when both factors are increased simultaneously, their effects are independent and add together to increase energy intake. On the other hand, reducing the energy density of a first course, while increasing the volume that is consumed, leads to a decrease in energy intake at the entire meal. The mechanisms by which both factors exert their influence are not well understood but likely include cognitive and orosensory factors as well as physiological controls related to gastric distention and gastric emptying. Findings from studies in this area of research provide evidence that the energy density and the portion size of foods are important determinants of energy intake. An environment in which the food supply is ample and large portions of energy-dense foods are readily available to consumers can contribute to an overconsumption of calories.

Diet↗
PubMed2006

The effect of increased beverage portion size on energy intake at a meal.

OBJECTIVE: This study examined the impact of increasing beverage portion size on beverage and food intake. SUBJECTS: Thirty-three subjects, 18 women and 15 men, were included. INTERVENTION: In a crossover design, subjects consumed lunch in the laboratory once a week for 6 weeks. At each test lunch, the same foods were served, but the beverage served was varied in type (cola, diet cola, or water) and portion size (360 g/12 fl oz or 540 g/18 fl oz). MAIN OUTCOME MEASURES: Beverage intake (g); energy intake from foods and beverages (kcal); and ratings of hunger, satiety, and characteristics of the foods and beverages served. RESULTS: Increasing beverage portion size significantly increased the weight of beverage consumed, regardless of the type of beverage served (P < 0.05). As a consequence, for the caloric beverage, energy intake from the beverage increased by 10% for women and 26% for men when there was a 50% increase in the portion served (P < 0.01). Food intake did not differ between conditions, so when the energy from the caloric beverage was added to the energy from food, total energy intake at lunch was increased significantly (P < 0.001) compared with noncaloric beverages. CONCLUSIONS: Serving a larger portion of beverage resulted in increased beverage consumption, and increased energy intake from the beverage when a caloric beverage was served. Serving a caloric beverage resulted in an overall increase in total energy consumed at lunch. Therefore, replacing caloric beverages with low-calorie or noncaloric beverages can be an effective strategy for decreasing energy intake.

Adolescent↗
PubMed2006

A computer-assisted instructional program for teaching portion size versus serving size.

Obesity is becoming an increasingly important community health threat, accounting for more than 300,000 deaths per year in the United States. The cumulative economic impact of obesity and overeating is enormous. Factors contributing to the problem include eating food away from home, consuming large or excessive quantities of soft drinks and snack foods, and large portion sizes. Discriminating between portion and serving sizes and determining the appropriate number of serving sizes to consume on a daily basis are key to maintaining a healthy diet. The purpose of this project was to create a computer-assisted instructional tool delineating serving size from portion size. The tool can be used by health care professionals to provide direct instruction to individuals or as part of a group approach to healthy eating.

Computer-Assisted Instruction↗
PubMed2004

Increasing the portion size of a sandwich increases energy intake.

OBJECTIVE: This study investigated the effect on energy intake of increasing the portion size of a food served as a discrete unit. DESIGN: A within-subject design with repeated measures was used. SUBJECTS/SETTING: The sample comprised 75 young adults (37 females and 38 males) from a university community. INTERVENTION: Individuals ate lunch in the lab once a week for 4 weeks. Each week, they were served one of four sizes of a deli-style sandwich (6, 8, 10, or 12 inches), of which they could eat as much as they wanted. MAIN OUTCOME MEASURES: Energy intakes were determined for each meal, as were ratings of hunger and satiety before and after each meal. STATISTICAL ANALYSES PERFORMED: A linear mixed model with repeated measures was used. The influence of subject characteristics was examined using analysis of covariance. RESULTS: The portion size of the sandwich significantly influenced lunch intake for both males and females (P<.0001). The majority of individuals consumed the entire 6-inch sandwich. When served the 12-inch sandwich, compared with the 8-inch sandwich, females consumed 12% more energy (74 kcal) and males consumed 23% more energy (186 kcal). Despite these differences, ratings of hunger and fullness were not significantly different after eating the 12-inch and 8-inch sandwiches. APPLICATIONS/CONCLUSIONS: These results suggest that increasing the portion size of a food served as a discrete unit leads to increased energy intake at a single meal without differentially influencing ratings of hunger and satiety. Dietitians should educate their clients about strategies to moderate the effect on intake of increased portions of high-calorie foods.

Adult↗
PubMed2006

Consumption and portion sizes of tree nuts, peanuts and seeds in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohorts from 10 European countries.

Tree nuts, peanuts and seeds are nutrient dense foods whose intake has been shown to be associated with reduced risk of some chronic diseases. They are regularly consumed in European diets either as whole, in spreads or from hidden sources (e.g. commercial products). However, little is known about their intake profiles or differences in consumption between European countries or geographic regions. The objective of this study was to analyse the population mean intake and average portion sizes in subjects reporting intake of nuts and seeds consumed as whole, derived from hidden sources or from spreads. Data was obtained from standardised 24-hour dietary recalls collected from 36 994 subjects in 10 different countries that are part of the European Prospective Investigation into Cancer and Nutrition (EPIC). Overall, for nuts and seeds consumed as whole, the percentage of subjects reporting intake on the day of the recall was: tree nuts = 4. 4%, peanuts = 2.3 % and seeds = 1.3 %. The data show a clear northern (Sweden: mean intake = 0.15 g/d, average portion size = 15.1 g/d) to southern (Spain: mean intake = 2.99 g/d, average portion size = 34.7 g/d) European gradient of whole tree nut intake. The three most popular tree nuts were walnuts, almonds and hazelnuts, respectively. In general, tree nuts were more widely consumed than peanuts or seeds. In subjects reporting intake, men consumed a significantly higher average portion size of tree nuts (28.5 v. 23.1 g/d, P<0.01) and peanuts (46.1 v. 35.1 g/d, P<0.01) per day than women. These data may be useful in devising research initiatives and health policy strategies based on the intake of this food group.

Arachis↗
PubMed2006

How well do adolescents determine portion sizes of foods and beverages?

In the present study, we examined how well adolescents (12-13 years) are able to select the correct dietary aid portion sizes after having been shown different food items. We also evaluated the effectiveness of two-dimensional life-size drawings and three-dimensional food models, used as dietary aids in this process. Fifty black children and 42 white children from Johannesburg participated in the study (N = 92). Trained interviewers individually tested each child following a prescribed sequence, throughout. Each participant was shown a plate of actual food of a pre-determined weight. The participant was required to select a two-dimensional drawing, and thereafter a three-dimensional food model, which most closely resembled the real food portion. In this manner, portion size estimation was evaluated with respect to 11 different food items. Correlations between nutrients calculated from actual weight of food portions and estimates ranged from 0.842 to 0.994 (P < 0.0001), indicating a significant positive linear association between the actual and estimated nutrients, using either of the dietary aids. However, findings also suggest that the drawings provided a better estimate of actual energy, fat and carbohydrates than did the food models (with respect to lying within the limits of agreement). On the other hand, the food models were more frequently selected correctly than the drawings. Hence, both methods had advantages and disadvantages. Overall, it was found that there were no gender differences (P < 0.05) when using either the models or drawings to estimate portion size, however, there were significant ethnic differences (P < 0.05). With two exceptions, black children selected the correct aids (drawings and models), more often compared with white children. It is recommended that in dietary interviews undertaken in black children in urban areas one could use either aid; while in white adolescents the use of the food models is recommended.

Adolescent↗
PubMed1979

Portion sizes, preparation and cooking yields, and plate waste in school meals.

Available portion sizes for a wide range of menu items were measured in seven junior schools and three senior schools in one local authority area. Serving waste was also measured and used as a criterion of acceptability. Portion sizes for entrees, desserts and potatoes were generally acceptable except for a few unpopular items. Custard was the most acceptable milky sauce. A small range of vegetables was acceptable in small quantities, but excess was rejected while others were almost totally rejected. Peeling, trimming and cooking yields for vegatables, trimming and cooking yields for meat, and plate waste were measured over one year in 180 schools in eight local authority areas. Results for vegetables compared favourably with previously published data except for new potatoes where the yield after machine peeling was lower. Cooking yields for pork, beef and lamb were slightly lower than previously published values. Trimming waste from meat for stewing was substantially greater than the 5 per cent visible fat which is the catering specification for ordering. The mean plate waste was 33 g per child meal (excluding bones).

Adolescent↗
PubMed2002

Assessing the diet of the British African-Caribbean population: frequency of consumption of foods and food portion sizes.

There is a very high prevalence of diet related disorders in the British African-Caribbean population but very few studies have determined associations between diet and disease within this community. There are virtually no published data on the frequency of foods consumed by this population or on the usual portion sizes which are necessary not only for nutritional epidemiological studies but also for treating diet related conditions such as diabetes. Here we present the frequency of foods consumed, assessed by a quantitative FFQ specifically developed for this sample, and the usual portion size reported by 210 randomly selected adult men and women. Frequency of consumption of foods and food portion sizes reported differed greatly from those consumed by the majority White population. This paper highlights the need to collect valid food consumption data for specific ethnic groups rather than using data available from another population, which is inappropriate. Such data will enable more precise dietary assessment and will further our understanding of the role of diet in the aetiology and prevention of diet-related diseases.

Black or African American↗
PubMed1999

Portion-size estimation training in second- and third-grade American Indian children.

Training in portion-size estimation is known to improve the accuracy of dietary self-reporting in adults, but there is no comparable evidence for children. To obtain this information, we studied 110 second- and third-grade American Indian schoolchildren (34 control subjects were not trained), testing the hypotheses that a 45-min portion-size estimation training session would reduce children's food quantity estimation error, and that the improvement would be dependent on food type, measurement type, or both. Training was a hands-on, 4-step estimation and measurement skill-building process. Mixed linear models (using logarithmic-transformed data) were used to evaluate within- and between-group differences from pre- to posttest. Test scores were calculated as percentage estimation errors by difference and absolute value methods. Mean within-group estimation error decreased significantly (P<0.05) from pre- to posttest for 7 of 12 foods (trained group) by both calculation methods, plus 3 additional foods by the difference method and one additional food by the absolute value method. Significant (P<0.05) between-group differences occurred for 3 foods, reflecting a greater decrease in estimation error for the trained group. Improvement was greatest for solid foods estimated by dimensions (P>0.05) or in cups (P<0.05), for liquids estimated by volume or by label reading (P<0.001), and for one amorphous food estimated in cups (P<0.01). Despite these significant improvements in estimation ability, the error for several foods remained >100% of the true quantity, indicating that more than one training session would be necessary to further increase dietary reporting accuracy.

Asian People↗
PubMed2004

Portion size of common foods predicts energy intake among preschool-aged children.

This study evaluated the relationship of food intake behaviors to total energy intake among children aged 2 to 5 years old (N=5447) who participated in the Continuing Survey of Food Intakes by Individuals, 1994-1996, 1998 (CSFII 94-96, 98). Food intake behaviors examined were portion size for 10 commonly eaten foods, number of eating occasions per day, and number of foods consumed per day. Using regression models, we examined these eating behaviors as predictors of energy intakes with adjustment for body weight. Eating behaviors and body weight were positively related to energy intake, together explaining 38% to 39% of the variability. Portion size alone accounted for 17% to 19% of the variance in energy intake, whereas body weight predicted only 4%. Feeding recommendations should highlight the importance of age-appropriate portion sizes and provide guidance on the frequency of eating and number of foods consumed.

Age Factors↗
PubMed2005

Portion sizes and the obesity epidemic.

The rise in obesity rates over the past 30 y has been paralleled by increases in the portion size of many foods and the prevalence of eating away from home. Foods of particular concern are those that have a high energy density (kJ/g). Many well-controlled, laboratory-based studies have found that large portions of energy-dense foods can lead to excess energy intakes. This influence of large portions on energy intake has been supported by data collected in naturalistic settings. Further research is needed to explore strategies that can be used to moderate the effects of portion size on food consumption. One promising strategy is to reduce the energy density of foods, while maintaining food weight or volume, so that consumers can eat satisfying portions while reducing their energy intakes. There is a need for effective educational messages that not only emphasize limiting the consumption of foods high in energy density, but also encourage the consumption of those with a low energy density, such as fruits and vegetables. The delivery of consistent messages will require more cooperation among the food and restaurant industries, policy makers, and scientists. Effective strategies will also require consumers to understand and accept the importance of eating reasonable portions for better health.

Body Mass Index↗
PubMed2004

Accuracy of reporting dietary intake using various portion-size aids in-person and via telephone.

OBJECTIVE: This study compared the accuracy with which respondents reported food intake using different portion-size estimation aids (PSEAs) and determined whether the interview technique affected the accuracy of reporting. DESIGN: Participants chose preweighed foods from a buffet line, leftovers were weighed, and actual amounts eaten were calculated. The next day during dietary interviews, participants estimated amounts eaten using one of four procedures, including telephone or in-person interviews, two-dimensional or three-dimensional PSEAs, and guiding or not guiding participants to certain aids. SUBJECTS: A total of 120 persons, ages 18 to 65 years, representing both genders were recruited through advertisements, local churches, and universities. STATISTICAL ANALYSIS: Analysis of variance and least significant differences were calculated for mean percentage estimation error. Frequencies and Pearson correlation coefficients were used to determine percentage misestimations and relationships between estimations and perceived healthfulness of the food and confidence in the estimate made. RESULTS: In general, accuracy of reporting food amounts was not significantly different for the different types of aids or for the interview technique. Participants frequently overestimated the intake by more than 20% for solids (four overestimations and zero underestimations) and liquids (13 overestimations and one underestimation), and both over- and underestimated amorphous (mounding) foods by more than 20% (six underestimations and seven overestimations). Misestimation was unrelated to perceived healthfulness of the food or respondent confidence in the estimate. CONCLUSIONS: In this study, portion-size data, based on PSEAs used in dietary recalls for estimating amounts eaten, were useful for measuring dietary intake for population-based studies. Individual respondent data, however, may be inaccurate and should be supplemented with additional information to improve assessment of individual nutritional status. Techniques such as telephone interviewing and guiding respondents to certain aids seem useful for reducing the burden of dietary assessment.

Adolescent↗
PubMed1995

Portion sizes in dietary assessment: issues and policy implications.

Accurate estimates of energy and nutrient intake of individuals and populations are contingent on the reliability of information obtained about food intake, food composition, and portion size. This article reviews issues related to the definition, determination, and use of portion sizes in dietary assessment and public education.

Eating↗
PubMed2004

Salad and satiety: energy density and portion size of a first-course salad affect energy intake at lunch.

OBJECTIVE: We tested the effect on meal intake of varying the energy density and portion size of a compulsory first-course salad. DESIGN: The study used a randomized crossover design. SUBJECTS/SETTING: Forty-two women from the State College, PA, university community ate lunch in the laboratory once per week for 7 weeks. INTERVENTION: Lunch comprised one of six first-course salads, or no salad in the control condition, followed by a main course of pasta. Subjects were required to consume the entire salad, but ate as much pasta as they wanted. The salads varied in energy density (0.33, 0.67, or 1.33 kcal/g) and portion size (150 or 300 g). The energy density of the salad was reduced by changing the amount and type of dressing and cheese. MAIN OUTCOME MEASURES: Energy intake and ratings of hunger, satiety, and food characteristics were measured. STATISTICAL ANALYSES PERFORMED: Outcomes were analyzed using a linear mixed model with repeated measures. RESULTS: Compared with having no first course, consuming the low-energy-dense salads reduced meal energy intake (by 7% for the small portion and 12% for the large), and consuming the high-energy-dense salads increased intake (by 8% for the small portion and 17% for the large). When two salads with the same number of calories were compared, meal intake was decreased when the large portion of the lower-energy-dense salad was consumed. CONCLUSIONS: Eating a low-energy-dense first course enhances satiety and reduces meal energy intake. Consuming a large portion of a low-energy-dense food at the start of a meal may be an effective strategy for weight management.

Adult↗
PubMed2004

Why All the Fuss About Portion Size?: Designing the New American Plate.

In attempting to respond to current public concerns about nutrition when creating its health education program, the New American Plate, the American Institute for Cancer Research found it necessary to emphasize the importance of portion size. Justifiable concern about overweight and obesity and as yet unproved ideas about weight management were causing people to distort the shape of their diet. The focus of the new education program was reduction of cancer risk through a predominantly plant-based diet. To ensure a cancer-protective proportion of plant food to animal food, the American Institute for Cancer Research had to expound gradual reduction of portion size, accompanied by increased exercise as the primary means of weight management.

Journal Article↗
PubMed2006

Gender differences in dietary intake among adults of Hindu communities in lowland Nepal: assessment of portion sizes and food consumption frequencies.

OBJECTIVE: To elucidate gender differences in dietary intake among adults in lowland Nepalese communities. SUBJECTS AND METHODS: For 122 male and 195 female subjects aged 20 years and over from 94 randomly selected households, interviews using a 19-item food frequency questionnaire were conducted. To determine the portion sizes of these foods, the samples consumed by 56 subjects in a full 1-day period were weighed. Energy expenditure was estimated by time spent on daily activities. RESULTS: Gender differences in per-day energy and protein intakes were related to sex differences in body size and energy expenditure. Apparent gender differences in the crude intakes disappeared when they were expressed by nutrient density (mg or microg/MJ) since micronutrient intakes were significantly correlated with energy intake. However, males' iron intake was larger even after adjustment for energy intake, attributing to their larger portion sizes of commonly consumed staple foods and higher frequencies of consuming luxury foods (fish and tea). CONCLUSION: The intrahousehold unequal distribution of food incurs risk of iron deficiency among female subjects. SPONSORSHIP: This study was financially supported by the Ajinomoto Foundation for Dietary Culture and the Alliance for Global Sustainability Program.

Adult↗
PubMed2003

The ecology of eating: smaller portion sizes in France Than in the United States help explain the French paradox.

Part of the "French paradox" can be explained by the fact that the French eat less than Americans. We document that French portion sizes are smaller in comparable restaurants, in the sizes of individual portions of foods (but not other items) in supermarkets, in portions specified in cookbooks, and in the prominence of "all you can eat" restaurants in dining guides. We also present data, from observations at McDonald's, that the French take longer to eat than Americans. Our results suggest that in the domain of eating, and more generally, more attention should be paid to ecological factors, even though their mechanism of operation is transparent, and hence less revealing of fundamental psychological processes. Ironically, although the French eat less than Americans, they seem to eat for a longer period of time, and hence have more food experience. The French can have their cake and eat it as well.

Adult↗