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Are you going to finish that? The dilemma of portion sizes

This week the Australian Financial Review reports that ” Small tableware makes for larger weight loss over time” referring to a new publication by the University of Cambridge and published in the Cochrane data base in which the authors conclude that:

“people consistently consume more food and drink when offered larger-sized portions, packages or tableware than when offered smaller-sized versions. This suggests that policies and practices that successfully reduce the size, availability and appeal of larger-sized portions, packages, individual units and tableware can contribute to meaningful reductions in the quantities of food (including non-alcoholic beverages) people select and consume in the immediate and short term.”

In this months JournalWatch Melissa Stoneham explores an Australian study that set out to test people’s understanding of portion sizes. You will be surprised to hear that adults and children had a somewhat different perceptions of an average serve of confectionary…

Melissa Stoneham writes:

Not that long ago, I was out with friends enjoying some great conversation and a few drinks (I was responsible!). We lingered a little longer than expected and decided some bar snacks would be just what we needed. The menu came out and some “sliders” were ordered. Being a mother of young children, I hadn’t been getting out much so I actually had to ask a friend what a slider was! I was informed it was a small burger. For me, this bar snack was going to be my dinner. But for some of my friends, these sliders were simply going to be a small treat between meals. This got me thinking….just what do people consider a portion size to be? Clearly I wasn’t this only one thinking this as this month’s JournalWatch feature is on this very topic. Led by Clare Collins from the University of Newcastle, this month’s article which is featured in the Health Promotion Journal of Australia aimed to quantify what adults and children deemed to be a typical portion for a variety of foods and then compared these with the serving sizes specified in the Australian Guide to Healthy Eating (AGHE). The study also aimed to assess participants’ perceptions of small, medium and large portion sizes.

Some commentators have suggested that serving size is one of the reasons that the obesity epidemic is upon us. It’s not rocket science is it? Put simply, the bigger the portion, the more you eat and the more kilojoules you consume. So is there a difference between serving size and portion? Manufacturers and the food industry recommend serving sizes for their food which are shown on the nutrition information panel or posted on websites. Not always easy to find or understand! These serving sizes are used to determine the percentage of daily intake figures for kilojoules and other nutrients that some manufacturers choose to display on food labels. Portion size, on the other hand, is the amount of food you actually serve up for yourself or buy to eat. In America, serving size is regulated by the Food and Drug Administration (FDA). In Australia, it’s up to the manufacturer to determine the serving sizes, which is highly criticised as serving sizes are often inconsistent between comparable products, even within the same brands, and some are simply unrealistic.

Now, we do know that people’s serving sizes are influenced by environmental factors such as lighting, socialising, package size and the size of the portion offered. We also know that being aware of how much you eat is key to consuming a more healthy diet or attempting to lose weight. So based on this, the authors suggest, that it makes sense to conclude that if a person knows what a serving size is, they should be able to self-monitor what they are consuming or to adhere to national dietary guidelines.

The pilot study recruited 21 adults and children who had some previous exposure to food frequency information, from the areas around Newcastle and Forster in NSW. The researchers set up ten food stations (one station per food) containing rice, breakfast cereal, soft drink, milk, mixed vegetables, steak, pasta, confectionary, ice cream, chocolate and potato crisps. These foods were selected as they represented categories of the AGHE. There was an overrepresentation of items from the energy-dense, nutrient-poor category such as soft drink and confectionary, because these foods are commonly consumed in amounts greater than recommended. The researchers placed the foods at each station in a large glass serving bowl in an amount that a family of four would consume. However, ice-cream was presented in a 2-L container which is a typical purchased container size. The participants in the study were asked to bring their own usual serving vessels (e.g. bowl, plate, cup) from home to improve estimation accuracy of their portion sizes.

At each food station, participants served themselves the typical amount of the food they would consume at a meal using their own serving vessel. They were asked to include any seconds. If their typical portion exceeded the capacity of the serving vessel, all amounts were added into the portion so that the participant achieved the amount they perceived as typical for one eating occasion. Each station had a set of electronic kitchen scales and served food portions were weighed by a trained assessor. Participants were then asked to sequentially serve themselves what they considered to be small, medium and large portions of the food.

The study found that the mean typical portion sizes served by both parents and children varied from the standard AGHE serving sizes for all foods, except for soft drink and milk. The serving sizes for both soft drink and milk were smaller than that recommended by the AGHE. Rice and pasta portions were also significantly different to the AGHE but only in the adults. Not surprisingly, there were differences in perceptions of ‘typical’ portions for confectionary between the adults and the kids! The parents reported portion sizes that closely aligned with the AGHE serving size (101%), but the children reported almost double that specified in the AGHE (247%).

When it comes to self-selected portion size, the children perceived portion sizes to be double that of the adults.The children also perceived the small, medium and large portion sizes to be double that of the adults. Out of all of this, the researchers recommended that self-assessment of serving sizes based on national food selection guides should be complemented with real food or realistic images of the specified serving size. So the old saying of ‘we eat with our eyes’ is actually ringing true!

So what to do? Clearly we need to invest in more education of our kids especially if these results are anything to go by and kids’ perception of portion sizes are double that of the adults. Others have attempted to provide education in a variety of ways. For example, there is a printable wallet-size portion control guide which has been designed to help keep you on track for the correct portion size, even when you’re on the go. And yes they have a fridge-size portion control guide too! Others have designed hand size symbols to measure portion size. Live Lighter has a fact sheet and the list goes on.

Of course, there are the strategies we can try as individuals such as using a smaller plate, avoiding going back for seconds, freezing left overs and aiming to fill half your plate with vegetables, one quarter with meat and alternatives (e.g. meat, chicken, legumes) and the last quarter with cereals and grains (e.g. rice, pasta, bread).

Food service providers are also addressing the issue and it’s not just the upmarket premises where quality rather than quantity is the focus. The fast food industry is also adjusting, with one example being Nigel Travis who is the CEO of Dunkin’ Donuts stating that his chain of stores has introduced a range of new sandwiches which are meant to be snacks — not lunch — to fit with the changing way people are eating. So after years of slinging supersized servings, it seems some fast-food chains are starting to see the benefits of offering smaller meals – most likely with profit rather than health in mind.

The answers are not easy – in this world of convenience, time poor consumers and changing norms, I think the answer to encouraging people to eat recommended portion sizes lies in a comprehensive approach where environmental factors, individual choice and ethical marketing and promotion are considered. I know – we have heard it all before – and there is a reason for that.

Article

Screen Shot 2015-09-15 at 9.13.01 pm

About JournalWatch

The Public Health Advocacy Institute WA (PHAIWA) JournalWatch service reviews 10 key public health journals on a monthly basis, providing a précis of articles that highlight key public health and advocacy related findings, with an emphasis on findings that can be readily translated into policy or practice.

 

These reviews are then emailed to all JournalWatch subscribers and are placed on the PHAIWA website. To subscribe click to Journal Watch click here.

Comments 1

  1. Rosemary Stanton says:

    Take a look at recipes too. When a recipe says it serves 4, the meat may range from 500g to 1kg.
    Paul Rozin and colleagues looked at serving sizes of )and time taken to consume ) similar foods in Paris and Philadelphia (see Psychol Sci. 2003 Sep;14(5):450-4.) and found dramatic differences in portion sizes (no prize for guessing that servings were much larger in Philadelphia (even for the same big brand name fast foods). They also found that the French took much longer to eat their smaller portions – so that’s another relevant factor.

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Pregnancy and childbirth
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Acknowledgement
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Croakey Conference News Service 2013 – 2019
2013 conferences
Australian Centre for Health Services Innovation Forum 2013
Australian Health Promotion Association Conference 2013
Closing the Credibility Gap 2013
CRANAplus Conference 2013
FASD Conference 2013
Health Workforce Australia 2013
International Health Literacy Network Conference 2013
NACCHO Summit 2013
National Rural Health Conference 2013
Oceania EcoHealth Symposium 2013
PHAA conference 2013
2014 conferences
#IPCHIV14
AIDA Conference 2014
Congress Lowitja 2014
CRANAplus conference 2014
Cultural Solutions - Healing Foundation forum 2014
Lowitja Institute Continuous Quality Improvement conference 2014
National Suicide Prevention Conference 2014
Racism and children/youth health symposium 2014
Rural & Remote Health Scientific Symposium 2014
2015 conferences
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Population Health Congress 2015
2016 conferences
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