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The NIH Weighs In

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The NIH Weighs In

Portion Size: What We Need to Know

There is considerable evidence that the portion and packaging sizes of many foods has increased over the last 30 years (Young and Nestle, 2002; Nielsen and Popkins, 2003; Church, 2008; Steenhuis et al., 2010; Piernas and Popkin, 2011) with the concern that this may be one factor that has contributed to the rise in obesity. In fact, it has become received wisdom that an increase in portion size has played a part in the raised incidence of obesity, yet the topic is not straightforward and the resulting advice has often been too certain; failing to reflect the existing state of knowledge and the complexity of the situation. Therefore, existing information, and gaps in our understanding, were both explored.

When considering the control of energy intake and the possibility of obesity, to date attention has been largely directed to physiological and biological events that occur towards the end of a meal; those that stop food intake. The physiological approach has found postingestive mechanisms at a molecular and cellular level that associate the storage of fat with changes in feeding behavior (Morton et al., 2006). Yet, food intake is often controlled more by external rather than internal cues. Such behavior occurs without awareness and the amount consumed is influenced by factors, such as portion size, the visibility of food, and the ease with which it can be obtained. Brunstrom (2011) noted that energy intake to a large extent depends on the size of the meal, something that is determined before we start eating. He makes the controversial suggestion that satiation plays a secondary role in the control of food intake: rather decisions about portion size made prior to eating play a predominant role.

Even if you accept that environmental factors are predominantly important our understanding of one these, portion size, is less than is often believed. What exactly can we say with any confidence about the influence of portion size on energy intake? What additional information do we need to establish?

Increasing Portion Sizes?

A “portion size” is the actual food that is placed on your plate, reflecting your own choice or the choice of the restaurant or food producer. It should be remembered, however, that in addition we need to know the amount consumed and any subsequent compensatory changes in the rest of the diet that may occur.

One thing that may appear to be uncontroversial is that the size of meals has increased over the years. Wansink and Wansink (2010) studied 52 of paintings of the Last Supper and found that over time the size of the meal had increased progressively. The size of the main meals grew by 69% between 1000 and the 1700, whereas the bread grew by 23%. The greatest increases were observed in paintings between 1500 and 1900. There is no religious reason for this change, so it is likely to reflect popular perceptions of the size of meals at different stages of history. However, although an increase in portion size may have been taking place for hundreds of years, more recently there is a concern that the phenomenon has speeded up. However, even the statement that portion sizes have increased needs some qualification.

Nielsen and Popkin (2003) compared surveys of food consumption in the United States, paying attention to those foods that had been responsible for the greatest increase in energy intake; salty snacks, desserts, soft drinks, fruit drinks, French fries, hamburgers, cheeseburgers, pizza, and Mexican food. This list of foods represented 18% of the calories consumed 1977–1978 but 27.7% in 1994–1996. The portion size had increased for all these food items, with the exception of pizza, resulting over this period in an increased caloric intake being associated with each portion of food that was eaten. Piernas and Popkin (2011) looked specifically at changes in portion size in foods eaten by children and adolescents in the USA from 1977 to 2006. When the list of foods considered in the previous analysis was again considered, the age of the child was important, In 2003–2006 these food items accounted for 38% of the energy intake of those between 13 and 18 years but only 28% of those between 2 and 6 years of age. At all ages, a larger portion size of pizza resulted in a greater energy intake at meals at which they were consumed. In those aged between 7 and 18 years, more energy was consumed at meals that included larger portions of sugar-sweetened drinks, French fries, or salty snacks. The influence of portion sizes was not, however, uniform: for example, the energy from a meal of a pizza was greater in African Americans, Hispanics, and those from low household education homes. An increase in the daily energy intake (179 kcal/day) between 1977 and 2006 was found to largely reflect that more calories were eaten away from home. Over this period, the percentage of calories eaten outside the home increased from 23.4 to 33.9%.

Young and Nestle (2002) similarly considered ready-to-eat foods and found that portion sizes had begun to increase in the 1970s and were still increasing to the extent that most of the portions exceeded the government-recommended serving sizes. For example, a typical muffin in the United States is 333% greater than the USDA recommendation, and a serving of pasta 480 percent larger. They also found that newer editions of cookbooks suggested fewer servings for the same amounts of ingredients.

It was clear in the USA that the consumption of larger portion sizes in part reflected where food was eaten; in particular the trend to eat more often in restaurants. Between 1977 and 1991 there was a 75% increase in the number of restaurants in the United States (US Bureau of the Census, 1984, 1995). In particular, fast food restaurants offer cheap meals in large quantities (Harnack et al., 2000). It is perhaps not surprising that there are reports that the frequency of eating in fast-food restaurants is associated with a greater energy and fat intake, and a higher body mass index (BMI) (McCrory et al., 1999). Based on data from 29,217 children, from 2 to 18 years, Poti and Popkin (2011) argued that the location in which children eat influences their energy intake. In particular, foods prepared away from home have been largely responsible for the increase in the total intake of calories. They concluded that in the USA changes in where meals were eaten, and the sources of foods consumed at home, had fueled the increase in the energy intake of children.

Although a great deal of the evidence comes from the USA, a Dutch survey found a trend toward larger portion sizes and the introduction of multipacks (Steenhuis et al., 2010). However, in France a study of cookery books found that the portions suggested were 25% less than in the United States (Rozin et al., 2003). In fact, French portion sizes were smaller in restaurants, in supermarkets, and in “all you can eat” restaurants.

Although there is a common perception that portion sizes have widely increased, the reality is more complex and precludes a simple conclusion. In the United Kingdom, the Food Standards Agency (Church, 2008) examined the association between food portion sizes, energy intake, and weight gain. They found that there was no simple increase in portion size over time as much depended on the food item. They found that “larger portion size packs are available for many, often premium products, including luxury cookies, American muffins, luxury ice cream bars, sausages, premium crisps, and chocolate confectionery.” But, in addition, smaller pack sizes were “available for many products (e.g., chocolate confectionery, savory snacks, soft drinks, ice cream cones, and bars) but usually as part of multipacks from larger retailers.” The portion sizes of many products, such as biscuits and cakes, had remained fairly constant and there were only a few cases where there had been a general increase in size, for example, individual ready meals. This difficulty in making generalizations about portion size was demonstrated by Smiciklas-Wright et al. (2003) who found that over time about one-third of 107 commonly eaten foods had changed in size, with the majority having increased, although some had decreased in size. Importantly, there was no food that consistently differed in portion size for every age group and gender, making a generalization impossible.

Read more @  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4337741/




2 Responses

Karen Martinez
Karen Martinez

November 10, 2019

Awesome idea! Can’t wait to purchase my own!! Sorry that Macy’s has taken such a negative hit on these. It what it is.

HP cheshire
HP cheshire

November 10, 2019

Love your plates. I need mindful reminders done with humor. Please tell me how I can purchase the “jeans” plate. Price per plate as I may order 2 or 4. Loved the plates.

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