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The Portion Size Effect and Strategies for Portion Control

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A special issue of Nutrients (ISSN 2072-6643).

Deadline for manuscript submissions: closed (1 October 2019) | Viewed by 51758

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Dr. Eva Almiron-Roig

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Guest Editor

Centre for Nutrition Research (CIN), Universidad de Navarra, Spain
Interests: Dietary assessment; Appetite & satiety regulation; community nutrition; public health nutrition

Prof. Marion Hetherington

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Guest Editor

School of Psychology, University of Leeds, UK
Interests: human ingestive behaviour; infant appetite; anorexia of ageing; eating disorders; food preference development in early life

Special Issue Information

Dear Colleagues,

Nutrients is currently running a Special Issue on portion sizes and energy balance.

Existing evidence has shown that exposure to large portions, especially of high energy-dense foods, results in increased energy intake, a phenomenon known as the portion size effect. Portion sizes have increased in recent years, generating the need for coping strategies to avoid overconsumption in an over-sized food environment. While most of the evidence on the effects of large portion sizes has come from controlled laboratory and field studies, a small number of studies indicate that smaller portions may help to reduce daily energy intake; however, more research on the longer-term effects of such strategies is needed. In addition, observational studies are needed to confirm such associations at the population level. This call is for research that addresses these gaps (both reviews as well as original research will be considered).

Potential topics may include, but are not limited to:

Changes and trends in portion size consumption and their relations with energy balance;
Individual, population and food level approaches to portion control;
Portion size management in special situations (childhood, older age, undernutrition, pregnancy, bariatric surgery, other);
Measurements of portion control practices in adults, children and the elderly;
Portion size education and training strategies;
Portion control strategies;
Tools and technology for portion size control.

Dr. Eva Almiron-Roig
Prof. Marion Hetherington
Guest Editors

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Keywords

portion size
serving size
portion size education
portion size training
food volume, food labels
nutrition education
energy balance
energy intake
weight management
portion size measurement aids
portion size estimation aids
food packaging
front of pack label
dietary guidelines
modelling study

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Published Papers (9 papers)

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Research

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17 pages, 278 KiB

Open AccessArticle

Snack Portion Sizes for Preschool Children Are Predicted by Caregiver Portion Size, Caregiver Feeding Practices and Children′s Eating Traits

by Sophie Reale, Rebecca M. Simpson, Colette Marr, Sharon A. Carstairs, Joanne E. Cecil, Marion M. Hetherington and Samantha J. Caton

Nutrients 2019, 11(12), 3020; https://doi.org/10.3390/nu11123020 - 10 Dec 2019

Cited by 8 | Viewed by 4480

Abstract

Caregivers are mostly responsible for the foods young children consume; however, it is unknown how caregivers determine what portion sizes to serve. This study examined factors which predict smaller or larger than recommended snack portion sizes in an online survey. Caregivers of children aged 2 to 4 years were presented with 10 snack images, each photographed in six portion sizes. Caregivers (n = 659) selected the portion they would usually serve themselves and their child for an afternoon snack. Information on child eating traits, parental feeding practices and demographics were provided by caregivers. Most caregivers selected portions in line with recommended amounts for preschool children, demonstrating their ability to match portion sizes to their child′s energy requirements. However, 16% of caregivers selected smaller than recommended low energy-dense (LED, e.g., fruits and vegetables) snacks for their child which was associated with smaller caregiver′s own portion size, reduced child food liking and increased satiety responsiveness. In contrast, 28% of caregivers selected larger than recommended amounts of high energy-dense (HED, e.g., cookies, crisps) snacks for their child which were associated with larger caregiver′s own portion size, greater frequency of consumption, higher child body mass index (BMI), greater pressure to eat and lower child food liking. These findings suggest that most caregivers in this study select portions adjusted to suit their child′s age and stage of development. Future interventions could provide support to caregivers regarding the energy and nutrient density of foods given the relatively small portion sizes of LED and large portions of HED snacks offered to some children. Full article

(This article belongs to the Special Issue The Portion Size Effect and Strategies for Portion Control)

17 pages, 273 KiB

Open AccessArticle

Maternal Decisions on Portion Size and Portion Control Strategies for Snacks in Preschool Children

by Sophie Reale, Colette Marr, Joanne E. Cecil, Marion M. Hetherington and Samantha J. Caton

Nutrients 2019, 11(12), 3009; https://doi.org/10.3390/nu11123009 - 9 Dec 2019

Cited by 8 | Viewed by 3618

Abstract

Caregivers are responsible for the type and amount of food young children are served. However, it remains unclear what considerations caregivers make when serving snacks to children. The aim of the study was to explore mothers’ decisions and portion control strategies during snack preparation in the home environment. Forty mothers of children aged 24–48 months participated in the study. Mothers prepared five snack foods for themselves and their child whilst verbalizing their actions and thoughts. Mothers were then asked about their portion size decisions in a semi-structured interview. Transcripts were imported into NVivo and analyzed thematically. Three key themes were identified: (1) portion size considerations, (2) portion control methods, and (3) awareness and use of portion size recommendations. Transient, food-related situational influences influenced mothers and disrupted planning and portion control. Food packaging and dishware size were used as visual cues for portion control; however, these vary widely in their size, thus emphasizing mothers’ uncertainty regarding appropriate portion sizes. Mothers called for portion size information to be accessible, child-centered, and simple. These findings reveal multiple considerations when deciding on the correct snack portion sizes for children. These decisions are complex and vary across situations and time, and according to the types of snacks offered. Full article

(This article belongs to the Special Issue The Portion Size Effect and Strategies for Portion Control)

17 pages, 563 KiB

Open AccessArticle

Determinants of Portion Size in Children and Adolescents: Insights from the UK National Diet and Nutrition Survey Rolling Programme (2008–2016)

by Pam Blundell-Birtill and Marion M. Hetherington

Nutrients 2019, 11(12), 2957; https://doi.org/10.3390/nu11122957 - 4 Dec 2019

Cited by 12 | Viewed by 4225

Abstract

Large portion sizes have been identified as contributing to overweight and obesity, particularly in children and adolescents. This study examined predictors of portion sizes of high energy snack foods eaten by children aged 1.5–18 years. Specifically, we examined whether portion sizes were adjusted for age, and what external features of the environment might be linked to large portion sizes. Portion sizes were derived from four-day food diaries that form the UK National Diet and Nutrition Survey. Diaries from 5942 children were examined and multilevel models were used to discover whether age, gender, location, time of day, household income, and watching TV while eating predicted portion sizes of savoury snacks, chocolate, confectionery and biscuits. Portion sizes of all the target foods were predicted by age. Boys had larger portions, and portion sizes were larger when target foods were consumed later in the day. Portion sizes were larger outside the home, for example in leisure venues, but the target foods were eaten more frequently in the home. As dietary patterns change to include more snack intake outside the home, these locations could be an important space to target for interventions for portion control. Full article

(This article belongs to the Special Issue The Portion Size Effect and Strategies for Portion Control)

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17 pages, 973 KiB

Open AccessArticle

Served Portion Sizes Affect Later Food Intake Through Social Consumption Norms

by Sanne Raghoebar, Ashleigh Haynes, Eric Robinson, Ellen Van Kleef and Emely De Vet

Nutrients 2019, 11(12), 2845; https://doi.org/10.3390/nu11122845 - 20 Nov 2019

Cited by 14 | Viewed by 10905

Abstract

Portion sizes of commercially available foods have increased, and there is evidence that exposure to portion sizes recalibrates what is perceived as ‘normal’ and subsequently, how much food is selected and consumed. The present study aims to explore the role of social (descriptive and injunctive) and personal portion size norms in this effect. Across two experiments, participants were either visually exposed to (Study 1, N = 329) or actually served (Study 2, N = 132) a smaller or larger than normal food portion. After 24 h, participants reported their intended consumption (Study 1) or served themselves and consumed (Study 2) a portion of that food and reported perceived portion size norms. In Study 1, visual exposure to portion size did not significantly affect intended consumption and perceived portion size norms. In Study 2, participants consumed a smaller portion of food when they were served a smaller rather than a larger portion the previous day, which was mediated by perceived descriptive and injunctive social (but not personal) portion size norms. Results suggest that being served (but not mere visual exposure to) smaller (relative to larger) portions changes perceived social norms about portion size and this may reduce future consumption of that food. Full article

(This article belongs to the Special Issue The Portion Size Effect and Strategies for Portion Control)

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13 pages, 263 KiB

Open AccessArticle

Quantifying Actual and Perceived Inaccuracy When Estimating the Sugar, Energy Content and Portion Size of Foods

by Laura M. König, Katrin Ziesemer and Britta Renner

Nutrients 2019, 11(10), 2425; https://doi.org/10.3390/nu11102425 - 11 Oct 2019

Cited by 13 | Viewed by 4722

Abstract

In order to adhere to dietary guidelines and manage health risks, consumers need to be able to estimate with some accuracy the sugar and energy content of foods. The present study compared how well participants could estimate the sugar and energy content of foods, the weight of foods, and approximate portion size (using a hand measure estimation aid). The study had three aims. First, it aimed to investigate differences in accuracy across the four measures. Second, it aimed to examine whether these differences in accuracy between estimation measures were accurately perceived by the participants. Third, it aimed to test if estimation accuracy was related to food journaling experience, body-mass index or gender. One hundred and ninety-seven participants took part in an estimation task and filled in a questionnaire. While the participants were inaccurate when using all four estimation measures, inaccuracy was most pronounced for sugar content (ds ≥ 0.39), which was consistently overestimated by between 62.1% and 98.5% of the sample. None of the other measures showed a consistent pattern of under- or overestimation. Participants’ perceived accuracy did not match their actual accuracy (rs ≤ |0.20|, ps ≥ 0.005). Actual accuracy showed only marginal covariation with food journaling experience (ts ≤ 2.01, ps ≥ 0.049, ds ≤ 0.14), body-mass index (rs ≤ |0.15|, ps ≥ 0.041) or gender (ts ≤ 3.17, ps ≥ 0.002, ds ≤ 0.46). It is particularly challenging for consumers to estimate the sugar content of food, which might have negative consequences for health and well-being. Thus, more education about sugar content and misperceptions is needed to support consumers so that they can make healthy food choices. Full article

(This article belongs to the Special Issue The Portion Size Effect and Strategies for Portion Control)

13 pages, 500 KiB

Open AccessArticle

Exploring the Experiences of People with Obesity Using Portion Control Tools—A Qualitative Study

by Eva Almiron-Roig, Anne Majumdar, David Vaughan and Susan A. Jebb

Nutrients 2019, 11(5), 1095; https://doi.org/10.3390/nu11051095 - 17 May 2019

Cited by 5 | Viewed by 4501

Abstract

Large portion sizes increase consumption and eating smaller portions is recommended as a weight control strategy. However, many people report difficulties enacting this advice. This study examined the experience of individuals using two commercially available portion-control tools to try to manage their weight. In a crossover design, 29 adults with obesity (18 women) who had attended a previous weight loss intervention in the community were invited to use two portion-control tool sets over a period of four weeks (two weeks each) and to complete a semi-structured questionnaire about their experience. The tools were a guided crockery set (sector plate, calibrated bowl, and calibrated glass) and a set of calibrated serving spoons (one for starch, one for protein, and one for vegetables). Data were analyzed using thematic framework analysis. A key theme was related to the educational benefits of the tools, such as generating awareness, guidance, and gaining an independent ability to judge appropriate portions. Other key themes were tool usability, acceptability, and feasibility of usage. Barriers identified by participants included unclear markings/instructions and the inconvenience of using the tool when eating away from home. Overall, the tools were perceived to be educationally useful, easy to use, and potentially effective for learning to control portions, which suggested that these instruments could help in weight management interventions alongside other strategies. Elements of the tool design could influence the ability of participants to adhere to using the tool, and hence allow the educational effect to be mediated. Full article

(This article belongs to the Special Issue The Portion Size Effect and Strategies for Portion Control)

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15 pages, 271 KiB

Open AccessArticle

Identifying Barriers to Reducing Portion Size: A Qualitative Focus Group Study of British Men and Women

by Jennifer Ferrar, Danielle Ferriday, Hendrik J. Smit, Duncan C. McCaig and Peter J. Rogers

Nutrients 2019, 11(5), 1054; https://doi.org/10.3390/nu11051054 - 10 May 2019

Cited by 4 | Viewed by 3951

Abstract

Reducing portion size might reduce meal satisfaction, which could minimize adherence to portion size interventions. The present study sought to identify the perceived barriers for consumers to eat smaller portions. A secondary aim explored the relative contribution of enjoyment of taste and post-meal fullness as determinants of meal satisfaction. Focus groups (N = 42) evaluated consumers’ feelings toward a small reduction in portion size. Thematic analysis of written free association tasks and open-ended group discussions revealed that most participants expected to feel hungry and unsatisfied, which motivated them to consume something else. However, others expected to feel comfortable, healthy, and virtuous. The acceptability of the reduced portion was also determined by meal characteristics (e.g., time and setting) and individual characteristics (e.g., predicted energy requirements). Compared to post-meal fullness, enjoyment of taste was perceived to be the more important determinant of meal satisfaction. In conclusion, interventions should present portion reduction as a marginal modification with little physiological consequence to energy reserves, while emphasizing the positive feelings (e.g., comfort, satisfaction, and self-worth) experienced after consuming a smaller portion. Additionally, focusing on taste enjoyment (rather than fullness) might be a useful strategy to maintain meal satisfaction despite a reduction in meal size. Full article

(This article belongs to the Special Issue The Portion Size Effect and Strategies for Portion Control)

13 pages, 1272 KiB

Open AccessArticle

Predicting Real-Life Eating Behaviours Using Single School Lunches in Adolescents

by Billy Langlet, Petter Fagerberg, Anastasios Delopoulos, Vasileios Papapanagiotou, Christos Diou, Christos Maramis, Nikolaos Maglaveras, Anna Anvret and Ioannis Ioakimidis

Nutrients 2019, 11(3), 672; https://doi.org/10.3390/nu11030672 - 20 Mar 2019

Cited by 3 | Viewed by 4152

Abstract

Large portion sizes and a high eating rate are associated with high energy intake and obesity. Most individuals maintain their food intake weight (g) and eating rate (g/min) rank in relation to their peers, despite food and environmental manipulations. Single meal measures may enable identification of “large portion eaters” and “fast eaters,” finding individuals at risk of developing obesity. The aim of this study was to predict real-life food intake weight and eating rate based on one school lunch. Twenty-four high-school students with a mean (±SD) age of 16.8 yr (±0.7) and body mass index of 21.9 (±4.1) were recruited, using no exclusion criteria. Food intake weight and eating rate was first self-rated (“Less,” “Average” or “More than peers”), then objectively recorded during one school lunch (absolute weight of consumed food in grams). Afterwards, subjects recorded as many main meals (breakfasts, lunches and dinners) as possible in real-life for a period of at least two weeks, using a Bluetooth connected weight scale and a smartphone application. On average participants recorded 18.9 (7.3) meals during the study. Real-life food intake weight was 327.4 g (±110.6), which was significantly lower (p = 0.027) than the single school lunch, at 367.4 g (±167.2). When the intra-class correlation of food weight intake between the objectively recorded real-life and school lunch meals was compared, the correlation was excellent (R = 0.91). Real-life eating rate was 33.5 g/min (±14.8), which was significantly higher (p = 0.010) than the single school lunch, at 27.7 g/min (±13.3). The intra-class correlation of the recorded eating rate between real-life and school lunch meals was very large (R = 0.74). The participants’ recorded food intake weights and eating rates were divided into terciles and compared between school lunches and real-life, with moderate or higher agreement (κ = 0.75 and κ = 0.54, respectively). In contrast, almost no agreement was observed between self-rated and real-life recorded rankings of food intake weight and eating rate (κ = 0.09 and κ = 0.08, respectively). The current study provides evidence that both food intake weight and eating rates per meal vary considerably in real-life per individual. However, based on these behaviours, most students can be correctly classified in regard to their peers based on single school lunches. In contrast, self-reported food intake weight and eating rate are poor predictors of real-life measures. Finally, based on the recorded individual variability of real-life food intake weight and eating rate, it is not advised to rank individuals based on single recordings collected in real-life settings. Full article

(This article belongs to the Special Issue The Portion Size Effect and Strategies for Portion Control)

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Review

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40 pages, 3467 KiB

Open AccessReview

Impact of Portion Control Tools on Portion Size Awareness, Choice and Intake: Systematic Review and Meta-Analysis

by M. Angeles Vargas-Alvarez, Santiago Navas-Carretero, Luigi Palla, J. Alfredo Martínez and Eva Almiron-Roig

Nutrients 2021, 13(6), 1978; https://doi.org/10.3390/nu13061978 - 9 Jun 2021

Cited by 16 | Viewed by 9790

Abstract

Portion control utensils and reduced size tableware amongst other tools, have the potential to guide portion size intake but their effectiveness remains controversial. This review evaluated the breadth and effectiveness of existing portion control tools on learning/awareness of appropriate portion sizes (PS), PS choice, and PS consumption. Additional outcomes were energy intake and weight loss. Published records between 2006–2020 (n = 1241) were identified from PubMed and WoS, and 36 publications comparing the impact of portion control tools on awareness (n = 7 studies), selection/choice (n = 14), intake plus related measures (n = 21) and weight status (n = 9) were analyzed. Non-tableware tools included cooking utensils, educational aids and computerized applications. Tableware included mostly reduced-size and portion control/calibrated crockery/cutlery. Overall, 55% of studies reported a significant impact of using a tool (typically smaller bowl, fork or glass; or calibrated plate). A meta-analysis of 28 articles confirmed an overall effect of tool on food intake (d = –0.22; 95%CI: –0.38, –0.06; 21 comparisons), mostly driven by combinations of reduced-size bowls and spoons decreasing serving sizes (d = –0.48; 95%CI: –0.72, –0.24; 8 comparisons) and consumed amounts/energy (d = –0.22; 95%CI: –0.39, –0.05, 9 comparisons), but not by reduced-size plates (d = –0.03; 95%CI: –0.12, 0.06, 7 comparisons). Portion control tools marginally induced weight loss (d = –0.20; 95%CI: –0.37, –0.03; 9 comparisons), especially driven by calibrated tableware. No impact was detected on PS awareness; however, few studies quantified this outcome. Specific portion control tools may be helpful as potentially effective instruments for inclusion as part of weight loss interventions. Reduced size plates per se may not be as effective as previously suggested. Full article

(This article belongs to the Special Issue The Portion Size Effect and Strategies for Portion Control)

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