A review of evidence supporting current strategies, challenges, and opportunities to reduce portion sizes

Abstract Although there is considerable evidence for the portion-size effect and its potential impact on health, much of this has not been successfully applied to help consumers reduce portion sizes. The objective of this review is to provide an update on the strength of evidence supporting strategies with potential to reduce portion sizes across individuals and eating contexts. Three levels of action are considered: food-level strategies (targeting commercial snack and meal portion sizes, packaging, food labels, tableware, and food sensory properties), individual-level strategies (targeting eating rate and bite size, portion norms, plate-cleaning tendencies, and cognitive processes), and population approaches (targeting the physical, social, and economic environment and health policy). Food- and individual-level strategies are associated with small to moderate effects; however, in isolation, none seem to have sufficient impact on food intake to reverse the portion-size effect and its consequences. Wider changes to the portion-size environment will be necessary to support individual- and food-level strategies leading to portion control.

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Comparing the portion size effect in women with and without extended training in portion control: A follow-up to the Portion-Control Strategies Trial

Appetite ◽

10.1016/j.appet.2018.01.012 ◽

2018 ◽

Vol 123 ◽

pp. 334-342 ◽

Cited By ~ 6

Author(s):

Faris M. Zuraikat ◽

Liane S. Roe ◽

Christine E. Sanchez ◽

Barbara J. Rolls

Keyword(s):

Size Effect ◽

Control Strategies ◽

Portion Size ◽

Portion Control ◽

Extended Training

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Do Behaviors Such As Eating Faster or Taking Larger Bites Moderate the Portion Size Effect?

Current Developments in Nutrition ◽

10.1093/cdn/nzab055_018 ◽

2021 ◽

Vol 5 (Supplement_2) ◽

pp. 1208-1208

Author(s):

Paige Cunningham ◽

Liane Roe ◽

Kathleen Keller ◽

Anouk Hendriks ◽

Barbara Rolls

Keyword(s):

Size Effect ◽

Random Coefficients ◽

Portion Size ◽

Controlled Study ◽

Eating Rate ◽

Bite Size ◽

Targeted Interventions ◽

Meal Intake ◽

Before And After ◽

Negative Effect

Abstract Objectives Individuals eat more when served larger portions, and this may be influenced by eating-related microstructural behaviors. In a controlled study, we explored whether microstructural components of eating such as eating rate, bite size, bite count, and meal duration influenced the portion size effect. Methods In a randomized crossover design, 44 adults aged 18 to 68 y (66% women; 45% with overweight or obesity) ate lunch in the laboratory once a week for four weeks. The meal consisted of a single dish of pasta (1.4 kcal/g) that was varied in portion size (400,500, 600, or 700 g) along with ∼700 g of water. Intake was assessed by weighing items before and after the meal. To characterize eating microstructure, meals were video-recorded to assess bite counts and meal duration, which were used to calculate mean eating rate (g/min) and mean bite size (g/bite). The influence of eating microstructure on the portion size effect was analyzed by random coefficients models. Results As larger portions were served, meal intake increased in a curvilinear manner (P < 0.0001). Compared to the smallest portion, intake of the largest portion increased by a mean (±SEM) of 123 ± 16 g (43%). As portions were increased, there were similar increases in bite count (35%) and meal duration (38%; both P < 0.0001), but only small increases in mean bite size (8%; P = 0.019) and no significant change in eating rate (P = 0.92). Measures of eating microstructure did not moderate the portion size effect but did have main effects on intake across all portions. Individuals ate more at the meal when they ate faster, took larger bites, took more bites, or ate for longer (all P < 0.0001). Body mass index did not influence eating microstructure or the strength of the portion size effect but had a modest negative effect on intake across all meals (−5.9 ± 2.7 g/unit increase in BMI; P = 0.046). Conclusions Eating-related microstructural behaviors influenced meal intake across portions, but did not moderate the effect of portion size on intake. Individuals who ate faster and took larger bites ate more across all portions, possibly as a result of reduced oro-sensory exposure, which can delay meal termination. Targeted interventions to alter components of eating microstructure have the potential as strategies to reduce overconsumption. Funding Sources NIDDK, Jenny Craig.

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How Mothers Cook in Chile: an Experimental Exercise to Use Food Labels to Control Portion Sizes

The Open Obesity Journal ◽

10.2174/1876823720130419002 ◽

2013 ◽

Vol 5 (1) ◽

pp. 22-29 ◽

Cited By ~ 1

Author(s):

Dario Gregori ◽

Simonetta Ballali ◽

Maria Gabriella Vecchio ◽

Luis Marcel Valenzuela Contreras ◽

Jorge Baeza Correa ◽

...

Keyword(s):

Consumer Attitudes ◽

Portion Size ◽

Nutrition Information ◽

Food Labels ◽

Food Label ◽

Nutritional Information ◽

Size Information ◽

Portion Sizes ◽

Food And Drink ◽

Children's Meals

Portion size of food and drink products is an important factor when providing nutrition information for food labeling purposes. The present study was conducted in order to understand more about consumer attitudes and understanding of portion size information on food and drink products. An experimental trial was performed on mothers and one of their relative. The participants were asked to prepare two meals (one meant for a child, one for an adult), with ingredients measured only with kitchen tools. Participants were stratified by portion size information in two groups, one with labels bearing the “100 gram” and one with “per portion”. Subsequently, every participant was interviewed on the basis of a questionnaire assessing nutritional and portioning knowledge. When measured the total Kcal of prepared meals after the simulation, an increase of calories was recorded in the group of subjects who prepared foods bearing the100g label, although not statistically significant(p =0.842). Portion size use seemed to be a more intuitive way to properly share nutritional information on food label, especially when considering common traditional recipes. Meals responsible appeared to be much more at ease with per portion labeling, when preparing both children's meals and adult ones.

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Serving size guidance for consumers: is it effective?

Proceedings of The Nutrition Society ◽

10.1017/s0029665112000766 ◽

2012 ◽

Vol 71 (4) ◽

pp. 610-621 ◽

Cited By ~ 39

Author(s):

G. P. Faulkner ◽

L. K. Pourshahidi ◽

J. M. W. Wallace ◽

M. A. Kerr ◽

T. A. McCrorie ◽

...

Keyword(s):

Chronic Exposure ◽

Consumer Behaviour ◽

Portion Size ◽

Direct Impact ◽

Food Labels ◽

Potential Barriers ◽

Portion Sizes ◽

The Impact ◽

Conflicting Messages ◽

Serving Size

Larger portion sizes (PS) may be inciting over-eating and contributing to obesity rates. Currently, there is a paucity of data on the effectiveness of serving size (SS) guidance. The aims of the present review are to evaluate SS guidance; the understanding, usability and acceptability of such guidance, its impact on consumers and potential barriers to its uptake. A sample of worldwide SS guidance schemes (n 87) were identified using targeted and untargeted searches, overall these were found to communicate various inconsistent and often conflicting messages about PS selection. The available data suggest that consumers have difficulty in understanding terms such as ‘portion size’ and ‘serving size’, as these tend to be used interchangeably. In addition, discrepancies between recommended SS and those present on food labels add to the confusion. Consumers generally understand and visualise SS best when expressed in terms of household measures rather than actual weights. Only a limited number of studies have examined the direct impact of SS guidance on consumer behaviour with equivocal results. Although consumers recognise that guidance on selecting SS would be helpful, they are often unwilling to act on such guidance. The challenge of achieving consumer adherence to SS guidance is formidable due to several barriers including chronic exposure to larger PS, distorted consumption norms and perceptions, the habit of ‘cleaning one's plate’ and language barriers for ethnic minorities. In conclusion, the impact of SS guidance on consumers merits further investigation to ensure that future guidance resonates with consumers by being more understandable, usable and acceptable.

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

Nutrients ◽

10.3390/nu13061978 ◽

2021 ◽

Vol 13 (6) ◽

pp. 1978

Author(s):

M. Angeles Vargas-Alvarez ◽

Santiago Navas-Carretero ◽

Luigi Palla ◽

J. Alfredo Martínez ◽

Eva Almiron-Roig

Keyword(s):

Weight Loss ◽

Weight Status ◽

Meta Analysis ◽

Portion Size ◽

Portion Control ◽

Portion Sizes ◽

Per Se ◽

Weight Loss Interventions ◽

Serving Sizes ◽

The Impact

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.

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

Nutrients ◽

10.3390/nu11123009 ◽

2019 ◽

Vol 11 (12) ◽

pp. 3009

Author(s):

Sophie Reale ◽

Colette Marr ◽

Joanne E. Cecil ◽

Marion M. Hetherington ◽

Samantha J. Caton

Keyword(s):

Food Packaging ◽

Visual Cues ◽

Control Strategies ◽

Structured Interview ◽

Portion Size ◽

Situational Influences ◽

Snack Foods ◽

Portion Control ◽

Portion Sizes ◽

Child Centered

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.

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Acceptability and potential effectiveness of commercial portion control tools amongst people with obesity

British Journal Of Nutrition ◽

10.1017/s0007114516004104 ◽

2016 ◽

Vol 116 (11) ◽

pp. 1974-1983 ◽

Cited By ~ 9

Author(s):

Eva Almiron-Roig ◽

Angélica Domínguez ◽

David Vaughan ◽

Ivonne Solis-Trapala ◽

Susan A. Jebb

Keyword(s):

Weight Control ◽

Ease Of Use ◽

Portion Size ◽

Perceived Effectiveness ◽

Obese Adults ◽

Portion Control ◽

Portion Sizes ◽

Professional Contact ◽

Weight Loss Programme ◽

The Impact

AbstractExposure to large portion sizes is a risk factor for obesity. Specifically designed tableware may modulate how much is eaten and help with portion control. We examined the experience of using a guided crockery set (CS) and a calibrated serving spoon set (SS) by individuals trying to manage their weight. Twenty-nine obese adults who had completed 7–12 weeks of a community weight-loss programme were invited to use both tools for 2 weeks each, in a crossover design, with minimal health professional contact. A paper-based questionnaire was used to collect data on acceptance, perceived changes in portion size, frequency, and type of meal when the tool was used. Scores describing acceptance, ease of use and perceived effectiveness were derived from five-point Likert scales from which binary indicators (high/low) were analysed using logistic regression. Mean acceptance, ease of use and perceived effectiveness were moderate to high (3·7–4·4 points). Tool type did not have an impact on indicators of acceptance, ease of use and perceived effectiveness (P>0·32 for all comparisons); 55 % of participants used the CS on most days v. 21 % for the SS. The CS was used for all meals, whereas the SS was mostly used for evening meals. Self-selected portion sizes increased for vegetables and decreased for chips and potatoes with both tools. Participants rated both tools as equally acceptable, easy to use and with similar perceived effectiveness. Formal trials to evaluate the impact of such tools on weight control are warranted.

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The Influence of Satiation Measures on the Portion Size Effect

Case Medical Research ◽

10.31525/ct1-nct03886428 ◽

2019 ◽

Author(s):

Keyword(s):

Size Effect ◽

Portion Size

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Analysis of the National Adult Nutrition Survey (Ireland) and the Food4Me Nutrition Survey Databases to Explore the Development of Food Labelling Portion Sizes for the European Union

Nutrients ◽

10.3390/nu11010006 ◽

2018 ◽

Vol 11 (1) ◽

pp. 6 ◽

Cited By ~ 1

Author(s):

Michael Gibney ◽

Aifric O’Sullivan ◽

Albert Flynn ◽

Janette Walton ◽

Hannelore Daniel ◽

...

Keyword(s):

European Union ◽

Survey Data ◽

Portion Size ◽

Food Labelling ◽

Food Diary ◽

Nutrition Survey ◽

Portion Sizes ◽

Food Portion ◽

Food Portion Size ◽

The Eu

The present study set out to explore the option of developing food portion size for nutritional labelling purposes using two European Union (EU) dietary surveys. The surveys were selected as they differed in (a) methodologies (food diary versus food frequency questionnaire), (b) populations (Irish National Adult Nutrition Survey (NANS) versus a seven-country survey based on the pan EU study Food4Me), (c) food quantification (multiple options versus solely photographic album) and (d) duration (4 consecutive days versus recent month). Using data from these studies, portion size was determined for 15 test foods, where portion size was defined as the median intake of a target food when consumed. The median values of the portion sizes derived from both the NANS and Food4Me surveys were correlated (r = 0.823; p < 0.00) and the mean of the two survey data sets were compared to US values from the Recognized as Customarily Consumed (RACC) database. There was very strong agreement across all food categories between the averaged EU and the US portion size (r = 0.947; p < 0.00). It is concluded that notwithstanding the variety of approaches used for dietary survey data in the EU, the present data supports using a standardized approach to food portion size quantification for food labelling in the EU.

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Inequality in active ageing: evidence from a new individual-level index for European countries

Ageing and Society ◽

10.1017/s0144686x17001052 ◽

2017 ◽

Vol 39 (3) ◽

pp. 541-567 ◽

Cited By ~ 8

Author(s):

MIKKEL BARSLUND ◽

MARTEN VON WERDER ◽

ASGHAR ZAIDI

Keyword(s):

Age Groups ◽

Positive Association ◽

European Countries ◽

Active Ageing ◽

Unequal Distribution ◽

Individual Level ◽

Country Level ◽

Challenges And Opportunities ◽

Share Data ◽

The Individual

ABSTRACTIn the context of emerging challenges and opportunities associated with population ageing, the study of inequality in active-ageing outcomes is critical to the design of appropriate and effective social policies. While there is much discussion about active ageing at the aggregate country level, little is known about inequality in active-ageing experiences within countries. Based on the existing literature on active ageing, this paper proposes an individual-level composite active ageing index based on Survey of Health, Ageing and Retirement in Europe (SHARE) data. The individual-level nature of the index allows us to analyse inequality in experiences of active ageing within selected European countries. One important motivation behind measuring active ageing at the individual level is that it allows for a better understanding of unequal experiences of ageing, which may otherwise be masked in aggregate-level measures of active ageing. Results show large differences in the distribution of individual-level active ageing across the 13 European countries covered and across age groups. Furthermore, there is a positive association between the country-level active ageing index and the equality of its distribution within a country. Hence, countries with the lowest average active ageing index tend to have the most unequal distribution in active-ageing experiences. For nine European countries, where temporal data are also available, we find that inequality in active-ageing outcomes decreased in the period 2004 to 2013.

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