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Ruby MB, Alvarenga MS, Rozin P. Differences in Portion Sizes in Brazil, France, and the USA. Foods 2024; 13:455. [PMID: 38338589 PMCID: PMC10855354 DOI: 10.3390/foods13030455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 01/20/2024] [Accepted: 01/26/2024] [Indexed: 02/12/2024] Open
Abstract
Portion size is recognized as a major determinant of food intake, at least over the short term, and could be related to overconsumption and obesity. In this study, we developed and evaluated a new visual measure of portion size (PS), examined whether the PS of chicken, ice cream, and soda varied among people in Brazil, France, and the USA, and tested whether PS was related to gender, body mass index, body weight, and socioeconomic status. We conducted a cross-sectional study using online convenience samples of university students (total N = 1391). Across all three foods, French personal and country PSs were significantly smaller than the other three countries. Estimated country PS was reliably larger than personal PS. Women's personal PSs were smaller than men's, but women's and men's estimates for country PS were similar. French personal and country PSs were the lowest. Some PSs had a weak but significant correlation with SES but were not significantly related to either weight or BMI. The study confirms French-American differences in personal PS and demonstrates that perceived norms correspond to individual PS.
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Affiliation(s)
- Matthew B. Ruby
- Department of Psychology, Counselling and Therapy, School of Psychology and Public Health, La Trobe University, Wodonga, VIC 3690, Australia
| | - Marle S. Alvarenga
- Program of Post Graduation in Public Health Nutrition, School of Public Health, University of São Paulo, São Paulo 01246-904, SP, Brazil;
| | - Paul Rozin
- Department of Psychology, University of Pennsylvania, Philadelphia, PA 19104, USA;
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2
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Papagiannaki M, Kerr MA. Food portion sizes: trends and drivers in an obesogenic environment. Nutr Res Rev 2024:1-17. [PMID: 38213262 DOI: 10.1017/s0954422424000027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Abstract
The prevalence of overweight and obesity in children and adults has increased worldwide. A strong environmental factor contributing to the obesity epidemic is food portion size (PS). This review evaluates the current evidence linking food PS to obesity, examines the effects of PS on energy intake (EI), and discusses the drivers of food PS selection. The leading causes of the rise in PS include globalisation, intensive farming methods, the impact of World War II, due to shortage of staple foods, and the notion of 'waste not, want not'. Large PS of energy-dense foods may stimulate overconsumption, leading to high EI levels. However, the studies have not shown a cause-and-effect relationship, due to confounding factors. Important mechanisms explaining the attractiveness of larger PS leading to higher EI levels are value for money, portion distortion, labels on food packaging, and tableware. Consumers depend on external rather than internal PS cues to guide consumption, irrespective of satiety levels. Further research is recommended on food consumption patterns to inform policymakers and provide information and insights about changes in diet.
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Affiliation(s)
- Maria Papagiannaki
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, BT52 1SA, UK
- Middlesex University, Department of Natural Sciences, The Burroughs, London, NW4 4BT, UK
| | - Maeve A Kerr
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, BT52 1SA, UK
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Sader M, Waiter GD, Williams JHG. The cerebellum plays more than one role in the dysregulation of appetite: Review of structural evidence from typical and eating disorder populations. Brain Behav 2023; 13:e3286. [PMID: 37830247 PMCID: PMC10726807 DOI: 10.1002/brb3.3286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 09/14/2023] [Accepted: 09/29/2023] [Indexed: 10/14/2023] Open
Abstract
OBJECTIVE Dysregulated appetite control is characteristic of anorexia nervosa (AN), bulimia nervosa (BN), and obesity (OB). Studies using a broad range of methods suggest the cerebellum plays an important role in aspects of weight and appetite control, and is implicated in both AN and OB by reports of aberrant gray matter volume (GMV) compared to nonclinical populations. As functions of the cerebellum are anatomically segregated, specific localization of aberrant anatomy may indicate the mechanisms of its relationship with weight and appetite in different states. We sought to determine if there were consistencies in regions of cerebellar GMV changes in AN/BN and OB, as well as across normative (NOR) variation. METHOD Systematic review and meta-analysis using GingerALE. RESULTS Twenty-six publications were identified as either case-control studies (nOB = 277; nAN/BN = 510) or regressed weight from NOR data against brain volume (total n = 3830). AN/BN and OB analyses both showed consistently decreased GMV within Crus I and Lobule VI, but volume reduction was bilateral for AN/BN and unilateral for OB. Analysis of the NOR data set identified a cluster in right posterior lobe that overlapped with AN/BN cerebellar reduction. Sensitivity analyses indicated robust repeatability for NOR and AN/BN cohorts, but found OB-specific heterogeneity. DISCUSSION Findings suggest that more than one area of the cerebellum is involved in control of eating behavior and may be differentially affected in normal variation and pathological conditions. Specifically, we hypothesize an association with sensorimotor and emotional learning via Lobule VI in AN/BN, and executive function via Crus I in OB.
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Affiliation(s)
- Michelle Sader
- Biomedical Imaging CentreUniversity of AberdeenAberdeenUK
| | | | - Justin H. G. Williams
- Biomedical Imaging CentreUniversity of AberdeenAberdeenUK
- School of MedicineGriffith UniversityGold CoastQueenslandAustralia
- Gold Coast Mental Health and Specialist ServicesGold CoastQueenslandAustralia
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Maneesing TU, Dawangpa A, Chaivanit P, Songsakul S, Prasertsri P, Yumi Noronha N, Watanabe LM, Nonino CB, Pratumvinit B, Sae-Lee C. Optimising blood glucose control with portioned meal box in type 2 diabetes mellitus patients: a randomised control trial. Front Nutr 2023; 10:1216753. [PMID: 37533574 PMCID: PMC10390788 DOI: 10.3389/fnut.2023.1216753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 07/04/2023] [Indexed: 08/04/2023] Open
Abstract
Background The impact of dietary factors on glycaemic control in type 2 diabetes mellitus (T2DM) is well established. However, the effectiveness of transforming portion control into a practical innovation for glycaemic control in T2DM has not yet been established for counselling in nutrition. The aim of this study was to compare the effect of general counselling in nutrition (GCN) and a portioned meal box (PMB) on fasting blood glucose, glycated haemoglobin (HbA1c) and body composition. Methods A randomised, parallel intervention trial was conducted over 12 weeks, with GCN: carbohydrate portion control concept by using food exchange lists (n = 25) and PMB: portioned meal box was set by energy requirements (n = 25). Results Both GCN and PMB demonstrated reductions in HbA1c levels at the 6th and 12th weeks compared to baseline. However, no significant difference in HbA1c was observed between GCN and PMB at either the 6th or 12th week. Using PMB at least four times a week significantly decreased HbA1c during the intervention period (p = 0.021 and p < 0.001 for weeks 6 and 12 when compared with baseline, respectively). Changes in body composition were observed: body weight decrease in PMB only, body fat decrease and constant muscle mass in both groups. Both methods tended to relieve hunger and increased satiety in both groups. The satisfaction evaluation showed that participants preferred to use PMB over GCN (p = 0.001). Additionally, participants consumed less energy, carbohydrate and fat in PMB (p = 0.001, p = 0.019, and p = 0.001, respectively) and less energy and fat in GCN (p = 0.006 and p = 0.001, respectively). Conclusion A better diet, either through GCN or PMB, can play an important role in improving dietary intake compliance and controlling blood glucose.
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Affiliation(s)
- Tanu-udom Maneesing
- Faculty of Allied Health Sciences, Burapha University, Chonburi, Thailand
- Exercise and Nutrition Innovation and Sciences Research Unit, Burapha University, Chonburi, Thailand
| | - Atchara Dawangpa
- Department of Clinical Pathology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- Research Division, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Pechngam Chaivanit
- Department of Internal Medicine, Faculty of Medicine, Burapha University, Chonburi, Thailand
| | - Sudjai Songsakul
- Department of Internal Medicine, Faculty of Medicine, Burapha University, Chonburi, Thailand
| | - Piyapong Prasertsri
- Faculty of Allied Health Sciences, Burapha University, Chonburi, Thailand
- Exercise and Nutrition Innovation and Sciences Research Unit, Burapha University, Chonburi, Thailand
| | | | - Lígia Moriguchi Watanabe
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Carla Barbosa Nonino
- Department of Health Sciences, Ribeirão Preto Medical School, São Paulo, Brazil
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Busadee Pratumvinit
- Department of Clinical Pathology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Chanachai Sae-Lee
- Department of Clinical Pathology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- Research Division, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Pepe RB, Lottenberg AM, Fujiwara CTH, Beyruti M, Cintra DE, Machado RM, Rodrigues A, Jensen NSO, Caldas APS, Fernandes AE, Rossoni C, Mattos F, Motarelli JHF, Bressan J, Saldanha J, Beda LMM, Lavrador MSF, Del Bosco M, Cruz P, Correia PE, Maximino P, Pereira S, Faria SL, Piovacari SMF. Position statement on nutrition therapy for overweight and obesity: nutrition department of the Brazilian association for the study of obesity and metabolic syndrome (ABESO-2022). Diabetol Metab Syndr 2023; 15:124. [PMID: 37296485 DOI: 10.1186/s13098-023-01037-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 03/23/2023] [Indexed: 06/12/2023] Open
Abstract
Obesity is a chronic disease resulting from multifactorial causes mainly related to lifestyle (sedentary lifestyle, inadequate eating habits) and to other conditions such as genetic, hereditary, psychological, cultural, and ethnic factors. The weight loss process is slow and complex, and involves lifestyle changes with an emphasis on nutritional therapy, physical activity practice, psychological interventions, and pharmacological or surgical treatment. Because the management of obesity is a long-term process, it is essential that the nutritional treatment contributes to the maintenance of the individual's global health. The main diet-related causes associated with excess weight are the high consumption of ultraprocessed foods, which are high in fats, sugars, and have high energy density; increased portion sizes; and low intake of fruits, vegetables, and grains. In addition, some situations negatively interfere with the weight loss process, such as fad diets that involve the belief in superfoods, the use of teas and phytotherapics, or even the avoidance of certain food groups, as has currently been the case for foods that are sources of carbohydrates. Individuals with obesity are often exposed to fad diets and, on a recurring basis, adhere to proposals with promises of quick solutions, which are not supported by the scientific literature. The adoption of a dietary pattern combining foods such as grains, lean meats, low-fat dairy, fruits, and vegetables, associated with an energy deficit, is the nutritional treatment recommended by the main international guidelines. Moreover, an emphasis on behavioral aspects including motivational interviewing and the encouragement for the individual to develop skills will contribute to achieve and maintain a healthy weight. Therefore, this Position Statement was prepared based on the analysis of the main randomized controlled studies and meta-analyses that tested different nutrition interventions for weight loss. Topics in the frontier of knowledge such as gut microbiota, inflammation, and nutritional genomics, as well as the processes involved in weight regain, were included in this document. This Position Statement was prepared by the Nutrition Department of the Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO), with the collaboration of dietitians from research and clinical fields with an emphasis on strategies for weight loss.
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Affiliation(s)
- Renata Bressan Pepe
- Grupo de Obesidade e Sindrome Metabolica, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, SP, Brazil
| | - Ana Maria Lottenberg
- Laboratório de Lipides (LIM10), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil.
- Nutrition Department of the Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO), Rua Mato Grosso 306 - cj 1711, Sao Paulo, SP, 01239-040, Brazil.
| | - Clarissa Tamie Hiwatashi Fujiwara
- Grupo de Obesidade e Sindrome Metabolica, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, SP, Brazil
| | - Mônica Beyruti
- Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO), São Paulo, SP, Brazil
| | - Dennys Esper Cintra
- Centro de Estudos em Lipídios e Nutrigenômica - CELN - University of Campinas, Campinas, SP, Brazil
| | - Roberta Marcondes Machado
- Liga Acadêmica de Controle de Diabetes do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil
| | - Alessandra Rodrigues
- Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO), São Paulo, SP, Brazil
| | - Natália Sanchez Oliveira Jensen
- Liga Acadêmica de Controle de Diabetes do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil
| | | | - Ariana Ester Fernandes
- Grupo de Obesidade e Sindrome Metabolica, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, SP, Brazil
| | - Carina Rossoni
- Instituto de Saúde Ambiental, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
| | - Fernanda Mattos
- Programa de Obesidade e Cirurgia Bariátrica do Hospital Universitário Clementino Fraga Filho da UFRJ, Rio de Janeiro, RJ, Brazil
| | - João Henrique Fabiano Motarelli
- Núcleo de Estudos e Extensão em Comportamento Alimentar e Obesidade (NEPOCA) da Universidade de São Paulo - FMRP/USP, Ribeirão Preto, Brazil
| | - Josefina Bressan
- Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, MG, Brazil
| | | | - Lis Mie Masuzawa Beda
- Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO), São Paulo, SP, Brazil
| | - Maria Sílvia Ferrari Lavrador
- Liga Acadêmica de Controle de Diabetes do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil
| | - Mariana Del Bosco
- Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO), São Paulo, SP, Brazil
| | - Patrícia Cruz
- Grupo de Obesidade e Sindrome Metabolica, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, SP, Brazil
| | | | - Priscila Maximino
- Instituto PENSI - Fundação José Luiz Egydio Setúbal, Instituto Pensi, Fundação José Luiz Egydio Setúbal, Hospital Infantil Sabará, São Paulo, SP, Brazil
| | - Silvia Pereira
- Núcleo de Saúde Alimentar da Sociedade Brasileira de Cirurgia Bariátrica e Metabólica, São Paulo, Brazil
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Liu Q, Wang L, Guo S, Allman-Farinelli M, Rangan A. Development and validation of an online tool to assess perceived portion size norms of discretionary foods. Eur J Clin Nutr 2023:10.1038/s41430-023-01290-y. [PMID: 37217622 PMCID: PMC10393777 DOI: 10.1038/s41430-023-01290-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 04/25/2023] [Accepted: 04/27/2023] [Indexed: 05/24/2023]
Abstract
BACKGROUND Perceived portion size norms (typical perception of how much of a given food individuals choose to eat at a single occasion) may have shifted towards larger sizes due to the ubiquity of large serving sizes. However, there is a lack of validated tools to assess such norms for energy-dense and nutrient-poor discretionary foods. This study aimed to develop and validate an online tool to examine the perceived portion size norms of discretionary foods. METHODS An online image-series tool of 15 commonly consumed discretionary foods was developed, with eight successive portion size options included for each food. Using a randomised-crossover design, adult consumers (18-65 years) completed the validation study in a laboratory session (April-May 2022) by reporting their perceived portion size norms for each food twice, once based on food images on a computer and another time based on equivalent real food portion size options at food stations in the laboratory. Agreement between methods for each test food was examined using cross-classification and intra-class correlation (ICC). RESULTS A sample of 114 subjects were recruited (mean age 24.8 years). Cross-classification indicated >90% of selections were matched in the same or adjacent portion size option. ICC was 0.85 across all foods, demonstrating a good level of agreement. CONCLUSION This novel online image-series tool developed to examine perceived portion size norms of discretionary foods showed good agreement with equivalent real food portion size options and may be valuable to investigate perceived portion size norms of common discretionary foods in future studies.
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Affiliation(s)
- Qingzhou Liu
- School of Life and Environmental Sciences, Faculty of Science, The University of Sydney, Sydney, NSW, 2006, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Leanne Wang
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia
- Discipline of Nutrition and Dietetics, Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
| | | | - Margaret Allman-Farinelli
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia
- Discipline of Nutrition and Dietetics, Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Anna Rangan
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia.
- Discipline of Nutrition and Dietetics, Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia.
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Watson MC, Lloyd J. Obesogenic environments: the UK government needs to act now. BMJ 2023; 381:940. [PMID: 37100448 DOI: 10.1136/bmj.p940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Affiliation(s)
| | - John Lloyd
- Institute of Health Promotion and Education, Lichfield, UK
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Gómez-Zúñiga RS, Wintergerst A. Effect of food portion on masticatory parameters in 8- to 10-year-old children. J Texture Stud 2023; 54:67-75. [PMID: 36146919 PMCID: PMC10092341 DOI: 10.1111/jtxs.12724] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 07/25/2022] [Accepted: 09/18/2022] [Indexed: 11/30/2022]
Abstract
The objective of this study was to explore differences in bite size and the amount of intraoral processing of four different foods between a reference and a double portion in 8- to 10-year-old children and, also to explore if there were differences depending on the child's weight status. The study was undertaken in 8- to 10-year-old children (n = 89). Body mass index was determined, and weight status was established based on Centers for Disease Control and Prevention(CDC) guidelines. A reference (half a banana, half a large peeled carrot, a slice of loaf cake, and half a salami stick), and a double portion of each food were offered to children in a randomized order in two different sessions. Three consecutive bites were taken and averaged. Variables in this study were bite size (g), number of cycles until swallowing, sequence duration as well as cycles/g. Comparisons were performed with Mann-Whitney, Kruskal-Wallis, and Wilcoxon tests, regressions and correlations were run. Bite size was ≈13% larger with the double portion (p ≤ .05 for salami, banana, and loaf cake). Cycles/g decreased for all foods with the double portion, although only significantly for banana and loaf cake. Normal and obese children had larger bite sizes (p ≤ .05) of banana than overweight children, while only obese had larger bites of loaf cake with the double portion. In conclusion, the bite size of foods in 8- to 10-year-old children increases (13%) when the portion size is doubled and the larger bite size leads to fewer cycles/g (8%). These effects differ among foods. These parameters do not depend on weight status.
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Affiliation(s)
- Roberto S Gómez-Zúñiga
- Graduate School of Dentistry, Universidad Nacional Autónoma de México, México City, Mexico
| | - Ana Wintergerst
- Graduate School of Dentistry, Universidad Nacional Autónoma de México, México City, Mexico.,Facultad de Estudios Superiores Zaragoza, Universidad Nacional Autónoma de México, México City, Mexico
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Cavalcante JB, de Vasconcelos TM, Sichieri R, Bezerra IN. Evolution of beverage portion sizes consumed in Brazil between 2008 and 2018. Front Public Health 2023; 10:969045. [PMID: 36711356 PMCID: PMC9874149 DOI: 10.3389/fpubh.2022.969045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 12/19/2022] [Indexed: 01/12/2023] Open
Abstract
Objective To describe the evolution of beverage portion sizes consumed in Brazil between 2008 and 2018. Methods Data from the dietary surveys of 2008-2009 and 2017-2018 Brazilian Household Budget Surveys, conducted with 34,003 and 46,164 individuals, respectively, were used to analyze the portion size of beverages. Food consumption data were used to group beverages according to nutritional characteristics, type and size of portions into eight groups: high-calorie soft drinks, fruit refreshments, alcoholic beverages, coffee/tea, fruit juices, milk and milk substitutes and ultra-processed milk-based beverages. The two-day food record and recall were considered to analyze the consumed portions. Comparisons between the surveys were done using Chi-Square tests and linear regression models. Results Between 2008 and 2018, the average portion consumed showed a significant increase for the group of alcoholic beverages (+29%), flavored juices (+11%), caloric soft drinks (+8%), milk and milk substitutes (+6%) and fruit juices (+5%); and reduction for the coffee/tea group (-11%). Analyzes by age group showed that among individuals between 20 and 40 years of age, the soft drinks and alcoholic beverage groups showed the greatest increase in portion size, +12 and +44%, respectively. Conclusion The beverage portion sizes consumed in Brazil between 2008 and 2018 increased for the group of alcoholic beverages, flavored juices, caloric soft drinks, milk and milk substitutes, and fruit juices.
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Affiliation(s)
- Jessica Brito Cavalcante
- Programa de Pós-Graduação em Nutrição e Saúde, Centro de Ciências da Saúde, Universidade Estadual do Ceará, Fortaleza, CE, Brazil
| | - Thais Meirelles de Vasconcelos
- Programa de Pós-Graduação em Saúde Coletiva, Centro de Ciências da Saúde, Universidade Estadual do Ceará, Fortaleza, CE, Brazil
| | - Rosely Sichieri
- Departamento de Epidemiologia, Instituto de Medicina Social, Universidade Estadual do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Ilana Nogueira Bezerra
- Programa de Pós-Graduação em Nutrição e Saúde, Centro de Ciências da Saúde, Universidade Estadual do Ceará, Fortaleza, CE, Brazil,*Correspondence: Ilana Nogueira Bezerra ✉
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10
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Hosni H, Giannakas K. The Economics of a "portion size reduction" policy. PLoS One 2022; 17:e0279165. [PMID: 36520871 PMCID: PMC9754238 DOI: 10.1371/journal.pone.0279165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 12/01/2022] [Indexed: 12/23/2022] Open
Abstract
This study develops novel models of heterogeneous consumer preferences for different dining options and imperfect competition among food suppliers to analyze the market and welfare effects of portion size reduction (PSR) for food away from home. Different scenarios on the nature of differentiation of the dining options, the information available to consumers, and their response to links between portion size and obesity, food waste, and climate change are considered within this framework. The market and welfare effects of the policy are quantified using a simulation analysis. The analysis shows that the market and welfare effects of the policy are case-specific and dependent on the relative magnitude of the cost and utility effects of PSR, the strength of the consumer preference for dining out, and the food suppliers' initial costs and degree of market power in the relevant markets. The policy can create winners and losers among consumers and accounting for consumer heterogeneity, as done in this study, is essential for capturing the asymmetric welfare effects of PSR. Intriguingly, consumers and suppliers can benefit from PSR even without accounting for any health or/and environmental benefits of reduced portion sizes.
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Affiliation(s)
- Hanin Hosni
- Department of Agricultural Economics, University of Nebraska-Lincoln, Lincoln, Nebraska, United States of America
| | - Konstantinos Giannakas
- Department of Agricultural Economics, University of Nebraska-Lincoln, Lincoln, Nebraska, United States of America
- * E-mail:
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11
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Mellos I, Probst Y. Evaluating augmented reality for 'real life' teaching of food portion concepts. J Hum Nutr Diet 2022; 35:1245-1254. [PMID: 35419898 PMCID: PMC9790224 DOI: 10.1111/jhn.13016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 04/06/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Estimation of food portions is a vital skill for dietitians, which is developed during formal nutrition training. Skill development is often accomplished by training with food portion estimation tools. These tools can vary in design but evaluations often reveal them to be limited in their effectiveness and generally impractical for everyday use. The aim of this study was to develop and evaluate an augmented reality (AR) tool for the estimation food portions. METHODS An online, quasi-experimental, randomised pre-test post-test study was conducted to evaluate the effectiveness of three food portion tools with nutrition students. These tools consisted of an online, AR, and an infographic tool (control). Students tested 10 different food images and were asked to estimate food portion sizes with and without assistance of a portion tool to determine absolute error, relative error, and overall improvement in estimation. RESULTS A total of 33 participants enrolled in the study with 26 (72.0%) completing the study. The mean absolute error was lowest in the online group (53.0%), followed by AR (59.5%) and control (64.0%). Relative error scores revealed higher accuracy for the AR group (45.5%) followed by online (43.5%), and control group (29.0%). Overall improvement in estimation was highest in the AR group (+12.2%) followed by the online (+11.6%) tool with a decrease seen for the infographic (-1.7%) tool. CONCLUSIONS The use of technology, notably AR technology, may provide some advantage when training nutrition students in food portion estimation, although further investigation is advised.
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Affiliation(s)
- Ioannis Mellos
- Smart Foods Centre, School of Medicine, Science Medicine and HealthUniversity of WollongongWollongongAustralia
| | - Yasmine Probst
- Smart Foods Centre, School of Medicine, Science Medicine and HealthUniversity of WollongongWollongongAustralia
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12
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Vargas-Alvarez MA, Al-Sehaim H, Brunstrom JM, Castelnuovo G, Navas-Carretero S, Martínez JA, Almiron-Roig E. Development and validation of a new methodological platform to measure behavioral, cognitive, and physiological responses to food interventions in real time. Behav Res Methods 2022; 54:2777-2801. [PMID: 35102518 PMCID: PMC8802991 DOI: 10.3758/s13428-021-01745-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2021] [Indexed: 01/01/2023]
Abstract
To fully understand the causes and mechanisms involved in overeating and obesity, measures of both cognitive and physiological determinants of eating behavior need to be integrated. Effectively synchronizing behavioral measures such as meal micro-structure (e.g., eating speed), cognitive processing of sensory stimuli, and metabolic parameters, can be complex. However, this step is central to understanding the impact of food interventions on body weight. In this paper, we provide an overview of the existing gaps in eating behavior research and describe the development and validation of a new methodological platform to address some of these issues. As part of a controlled trial, 76 men and women self-served and consumed food from a buffet, using a portion-control plate with visual stimuli for appropriate amounts of main food groups, or a conventional plate, on two different days, in a random order. In both sessions participants completed behavioral and cognitive tests using a novel methodological platform that measured gaze movement (as a proxy for visual attention), eating rate and bite size, memory for portion sizes, subjective appetite and portion-size perceptions. In a sub-sample of women, hormonal secretion in response to the meal was also measured. The novel platform showed a significant improvement in meal micro-structure measures from published data (13 vs. 33% failure rate) and high comparability between an automated gaze mapping protocol vs. manual coding for eye-tracking studies involving an eating test (ICC between methods 0.85; 90% CI 0.74, 0.92). This trial was registered at Clinical Trials.gov with Identifier NCT03610776.
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Affiliation(s)
- M A Vargas-Alvarez
- Center for Nutrition Research, University of Navarra, 31008, Pamplona, Spain
- Department of Nutrition, Food Science and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, Pamplona, Spain
| | - H Al-Sehaim
- School of Biological and Health Sciences, Technological University Dublin, Dublin, Ireland
| | - J M Brunstrom
- School of Psychological Science, University of Bristol, Bristol, UK
| | - G Castelnuovo
- Center for Nutrition Research, University of Navarra, 31008, Pamplona, Spain
| | - S Navas-Carretero
- Center for Nutrition Research, University of Navarra, 31008, Pamplona, Spain
- Department of Nutrition, Food Science and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, Pamplona, Spain
- Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition (CIBERobn), Institute of Health Carlos III, Madrid, Spain
- Navarra Institute for Health Research (IdiSNa), Pamplona, Spain
| | - J A Martínez
- Department of Nutrition, Food Science and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, Pamplona, Spain
- Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition (CIBERobn), Institute of Health Carlos III, Madrid, Spain
| | - E Almiron-Roig
- Center for Nutrition Research, University of Navarra, 31008, Pamplona, Spain.
- Department of Nutrition, Food Science and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, Pamplona, Spain.
- Navarra Institute for Health Research (IdiSNa), Pamplona, Spain.
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Liu Q, Wang L, Allman-Farinelli M, Rangan A. Systematic review of the portion size norm of discretionary foods. Nutr Rev 2022; 81:531-554. [PMID: 36137249 DOI: 10.1093/nutrit/nuac074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
CONTEXT Portion size norm is described as the perception of how much of a given food people choose to eat. Reducing the portion size norm of foods that are high in saturated fat, added sugar, and added salt toward smaller sizes might be a potential strategy to promote appropriate portion size selections. However, an overview of existing portion size norms for discretionary foods has yet to be established. OBJECTIVE The aim of this systematic review was to examine the portion size norm of discretionary foods and assess the methodologies used to investigate the norm. DATA SOURCES The literature search was conducted in 6 databases following the PRISMA guidelines (from inception to January 2022). DATA EXTRACTION Forty studies were eligible and grouped into 3 categories by portion size norm measures: normal (n = 26), appropriate (n = 8), and preferred portion sizes (n = 3). Study quality was assessed using the Joanna Briggs Institute Critical Appraisal Tools. DATA ANALYSIS A wide range of portion sizes were considered normal for each food type, with means/medians varying from 2- to 4-fold among studies. Studies differed considerably in design, with variables including the setting, food type, food presentation, the manner in which portion-size-related questions were formulated, and the range and number of displayed serving size options. The quality of reviewed studies was mixed (25 studies had low or moderate risk of bias, 15 had high risk of bias), and the method of assessing portion size was not validated in 15 of 33 quantitative studies. CONCLUSION The assessment of portion size in future studies should be conducted using tools that are validated for the population of interest so that more definitive conclusions can be drawn regarding portion size norms for discretionary foods. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration number CRD42021249911.
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Affiliation(s)
- Qingzhou Liu
- Faculty of Science, School of Life and Environmental Sciences, The University of Sydney, Sydney, New South Wales, Australia.,Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Leanne Wang
- the Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia.,the Faculty of Medicine and Health, Discipline of Nutrition and Dietetics, Susan Wakil School of Nursing and Midwifery, The University of Sydney, Sydney, New South Wales, Australia
| | - Margaret Allman-Farinelli
- the Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia.,the Faculty of Medicine and Health, Discipline of Nutrition and Dietetics, Susan Wakil School of Nursing and Midwifery, The University of Sydney, Sydney, New South Wales, Australia
| | - Anna Rangan
- the Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia.,the Faculty of Medicine and Health, Discipline of Nutrition and Dietetics, Susan Wakil School of Nursing and Midwifery, The University of Sydney, Sydney, New South Wales, Australia
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14
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Hendriks-Hartensveld AE, Brodock JL, Hayes JE, Rolls BJ, Keller KL, Havermans RC. The relative importance of complexity, variety, and portion size in ice cream preference in Dutch and American participants. Food Qual Prefer 2022. [DOI: 10.1016/j.foodqual.2021.104523] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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15
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Ndambo MK, Nyondo-Mipando AL, Thakwalakwa C. Eating behaviors, attitudes, and beliefs that contribute to overweight and obesity among women in Lilongwe City, Malawi: a qualitative study. BMC Womens Health 2022; 22:216. [PMID: 35681137 PMCID: PMC9185864 DOI: 10.1186/s12905-022-01811-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 06/03/2022] [Indexed: 11/17/2022] Open
Abstract
Background Obesity is increasingly a public health concern in low- and middle-income countries, including Malawi where 36% of women have body mass index in overweight/obese categories in urban areas. Eating behaviors, attitudes, and beliefs are associated with body size, but have not been studied in-depth in sub-Saharan African countries. This study therefore, explored eating behaviors, attitudes, and beliefs of women in Lilongwe, Malawi.
Methods This was a descriptive ancillary qualitative study utilising in-depth interviews with 27 women (13 in normal weight range and 14 in overweight/obesity ranges) puporsively selected in Lilongwe City, Malawi from October to November 2017. The concept of data saturation guided data collection, and it was reached with the 27 interviewed participants when there was no new information coming from the participants. All interviews were conducted in the local language, transcribed verbatim, and translated into English. The transcripts were analysed manually using thematic content analysis. Results Majority of participants perceived overweight as an indication of good health such that with food affordability, women deliberately gain weight to demonstrate their good health. Most normal weight respondents said they ate less food than they wanted to because of financial constraints. Most women in overweight/obese ranges in our sample reported that they eat large portions and eat frequently due to the desire to portray a good image of their marital life since there is a societal expectation that when a woman is married, her weight should increase to show that the marriage is successful. The perceived contributors to weight gain include eating behaviors, feelings about weight gain, and gender roles and social expectations to gain weight. Conclusion Beliefs and attitudes related to eating behaviors may have contributed to women being in overweight range and should be considered in designing obesity prevention interventions targeting women in Malawi. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-022-01811-0.
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Affiliation(s)
- Myness Kasanda Ndambo
- School of Global and Public Health, Kamuzu University of Health Sciences, Chichiri, Private Bag 360, Blantyre 3, Malawi.
| | - Alinane Linda Nyondo-Mipando
- School of Global and Public Health, Kamuzu University of Health Sciences, Chichiri, Private Bag 360, Blantyre 3, Malawi
| | - Chrissie Thakwalakwa
- Centre for Social Research, Chancellor College, University of Malawi, Zomba, Malawi
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16
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Duszka K, Hechenberger M, Dolak I, Kobiljak D, König J. Gender, Age, Hunger, and Body Mass Index as Factors Influencing Portion Size Estimation and Ideal Portion Sizes. Front Psychol 2022; 13:873835. [PMID: 35645850 PMCID: PMC9130823 DOI: 10.3389/fpsyg.2022.873835] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 04/19/2022] [Indexed: 11/13/2022] Open
Abstract
Portion sizes of meals have been becoming progressively larger which contributes to the onset of obesity. So far, little research has been done on the influence of body weight on portion size preferences. Therefore, we assessed whether Body Mass Index (BMI), as well as other selected factors, contribute to the estimation of food portions weight and the subjective perception of portion sizes. Through online questionnaires, the participants were asked to estimate the weight of pictured foods in the first study. In the second study, the participants indicated how the depicted varying portion sizes of different meals relate to their actual consumed real-life portion sizes. A total of 725 and 436 individuals were included in the statistical analysis in the first and second study, respectively. BMI and gender had a small effect on the capacity to estimate the weight of foods. The main predictor for portion size choices was the factor gender with men estimating ideal portion sizes as larger than women. Further, age and hunger together with external and restrictive eating behaviors were among the deciding factors for portion size choices. As expected, externally motivated eaters chose bigger portions while restrictive individual smaller ones. Gender- and age-related differences in portion size preferences likely reflect distinct energy requirements. The individuals with a higher BMI do not differ strongly from other BMI groups in their portion-related preferences. Therefore, other factors such as meal frequency, snacking, or a lifestyle, may contribute more to the onset, development, and maintenance of overweight.
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Affiliation(s)
- Kalina Duszka
- Department of Nutritional Sciences, University of Vienna, Vienna, Austria
| | | | - Irene Dolak
- Department of Nutritional Sciences, University of Vienna, Vienna, Austria
| | - Deni Kobiljak
- Department of Nutritional Sciences, University of Vienna, Vienna, Austria
| | - Jürgen König
- Department of Nutritional Sciences, University of Vienna, Vienna, Austria
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17
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Malhotra A, Verma A, Kaur D, Ranjan P, Kumari A, Madan J. A Stepwise Approach to Prescribe Dietary Advice for Weight Management in Postpartum and Midlife Women. J Obstet Gynaecol India 2022; 72:114-124. [PMID: 35492860 PMCID: PMC9008112 DOI: 10.1007/s13224-022-01643-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 02/24/2022] [Indexed: 11/29/2022] Open
Abstract
Weight retention and weight gain during the postpartum and midlife period subsequently increase the risk of chronic health conditions, thereby deteriorating the overall health. Dietary intervention is the pivotal component of sustainable weight management. However, in resource restricted settings, where dietitians may not be present, other healthcare professionals such as physicians, obstetricians, and paediatricians should play a vital role in providing timely weight management advice to these women. Therefore, this article provides dietary advice including the setting of realistic weight loss goals, identifying an individual's calorie needs, distribution of macronutrients and consideration of important micronutrients. Healthcare professionals can follow the stepwise approach to prescribe dietary advice to postpartum and midlife women for their weight management. Various dietary principles such as cultural and regional preferences of an individual, portion size, hypocaloric diets, nutrient-dense meals, eating habits, cultural beliefs and myths along with co-morbid conditions should be taken into consideration by healthcare professionals while providing the dietary prescription. Supplementary Information The online version contains supplementary material available at 10.1007/s13224-022-01643-w.
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Affiliation(s)
- Anita Malhotra
- Department of Home Science, Lakshmibai College, University of Delhi, New Delhi, India
| | - Aditi Verma
- Department of Home Science, University of Delhi, New Delhi, India
| | - Divjyot Kaur
- Department of Home Science, University of Delhi, New Delhi, India
| | - Piyush Ranjan
- Department of Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029 India
| | - Archana Kumari
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Jagmeet Madan
- Department of Food Nutrition and Dietetics, Sir Vithaldas Thackersey College of Home Science, SNDT Women’s University, Mumbai, India
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External food cue responsiveness and emotional eating in adolescents: A multimethod study. Appetite 2022; 168:105789. [PMID: 34728251 PMCID: PMC8671220 DOI: 10.1016/j.appet.2021.105789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 10/18/2021] [Accepted: 10/29/2021] [Indexed: 01/03/2023]
Abstract
Eating in response to external food cues (i.e., external eating) and internal emotional experiences (i.e., emotional eating) are associated with obesity. While external and emotional eating co-occur, little is known about how external food cue responsiveness may interact with internal emotional cues to influence eating episodes in adolescents. The current study examined how trait-level external food cue responsiveness modulates momentary associations between affective states and eating in adolescents. Participants were drawn from a prior study of siblings (N = 78; ages 13-17) who completed an ecological momentary assessment protocol to assess eating episodes and affective states. External food cue responsiveness was determined by comparing energy consumption following presentation of an appetizing food (pizza) on one day and a control activity (reading) on another day. Generalized linear mixed models examined positive and negative affective states, cue responsiveness, and their interactions as predictors of the likelihood of eating. The relationship between affective states and likelihood of eating was stronger among adolescents with higher versus lower external food cue responsiveness. Among adolescents with higher cue responsiveness, endorsing negative affect was associated with a lower likelihood of eating, whereas endorsing positive affect was associated with a higher likelihood of eating (within-person effects). Findings suggest that high sensitivity to external food cues and greater proclivity for emotional eating may be likely to coincide such that any cue, internal or external, is likely to disrupt sensitivity to internal hunger and satiety signals. Future studies are needed to elucidate how sensitivities to internal and external cues may interact to influence obesity risk.
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19
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Porter A, Toumpakari Z, Kipping R, Summerbell C, Johnson L. Where and when are portion sizes larger in young children? An analysis of eating occasion size among 1·5-5-year-olds in the UK National Diet and Nutrition Survey (2008-2017). Public Health Nutr 2021; 25:1-12. [PMID: 34955105 PMCID: PMC9991682 DOI: 10.1017/s1368980021005024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To identify eating occasion-level and individual-level factors associated with the consumption of larger portions in young children and estimate their relative importance. DESIGN Cross-sectional. SETTING Data from parent-reported 4-d food diaries in the UK National Diet and Nutrition Survey (2008-2017) were analysed. Multilevel models explored variation in eating occasion size (kJ) within (n 48 419 occasions) and between children (n 1962) for all eating occasions. Eating contexts: location, eating companion, watching TV, and sitting at a table and individual characteristics: age, gender, ethnicity and parental socio-economic status were explored as potential correlates of eating occasion size. PARTICIPANTS Children aged 1·5-5 years. RESULTS Median eating occasion size was 657 kJ (IQR 356, 1117). Eating occasion size variation was primarily attributed (90 %) to differences between eating occasions. Most (73 %) eating occasions were consumed at home. In adjusted models, eating occasions in eateries were 377 kJ larger than at home. Eating occasions sitting at a table, v. not, were 197 kJ larger. Eating in childcare, with additional family members and friends, and whilst watching TV were other eating contexts associated with slightly larger eating occasion sizes. CONCLUSIONS Eating contexts that vary from one eating occasion to another are more important than demographic characteristics that vary between children in explaining variation in consumed portion sizes in young children. Strategies to promote consumption of age-appropriate portion sizes in young children should be developed, especially in the home environment, in eating contexts such as sitting at the table, eating with others and watching TV.
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Affiliation(s)
- Alice Porter
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, BristolBS8 2BN, UK
| | - Zoi Toumpakari
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, BristolBS8 2BN, UK
| | - Ruth Kipping
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Carolyn Summerbell
- Department of Sport and Exercise Sciences, Durham University, Durham, UK
- Fuse, NIHR Centre for Translational Research in Public Health, London, UK
| | - Laura Johnson
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, BristolBS8 2BN, UK
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Liu Q, Tam LY, Rangan A. The Effect of Downsizing Packages of Energy-Dense, Nutrient-Poor Snacks and Drinks on Consumption, Intentions, and Perceptions-A Scoping Review. Nutrients 2021; 14:nu14010009. [PMID: 35010886 PMCID: PMC8746546 DOI: 10.3390/nu14010009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 12/06/2021] [Accepted: 12/15/2021] [Indexed: 01/12/2023] Open
Abstract
The single-serve packaging of discretionary foods is becoming increasingly popular, but evidence is limited on whether smaller package sizes can reduce food intake. The aim of this scoping review is to assess the effect of reducing the package size of energy-dense, nutrient-poor (EDNP) snacks and drinks on consumption, intentions, and perception, and to examine the effects of potential moderators or mediators. The search was conducted in six selected databases and grey literature sources, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for the scoping review process (PRISMA-ScR) guidelines. After screening 5562 articles, 30 articles comprising 47 intervention studies were included. Twelve of 15 studies found a significant effect in lowering the actual or intended consumption when a single smaller package was offered compared with a single larger package. When the total serving size was held constant between varying package conditions, such as a multipack, single package, or unpackaged, the results on the actual and intended consumption were inconsistent and varied according to the presence of moderators. Overall, these findings suggest that an overall reduction in the size of a single package is a more promising strategy than providing multipacks to reduce consumption. Changes to the current food environment to promote single smaller packages of EDNP snacks and drinks are necessary to support the better selection of appropriate portion sizes and reduce consumption.
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21
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Vinayachandran G, Patel N, Mathavaswami V, Subitha L. Food portion size educational programme in a workplace setting in Puducherry - Is it effective? J Family Med Prim Care 2021; 10:3368-3373. [PMID: 34760759 PMCID: PMC8565166 DOI: 10.4103/jfmpc.jfmpc_849_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 07/01/2021] [Accepted: 07/09/2021] [Indexed: 11/04/2022] Open
Abstract
Background: Consuming larger portion sizes, i.e., in excess of a typically recommended serving size, has been attributed to the obesity epidemic. The workplace acts as an efficient target for health promotion activities. Aims: To assess the effectiveness of a food portion size educational programme in increasing knowledge among the employees of a software company in Puducherry. Methodology: An interventional study was conducted with a pre-post design. A single group of software company employees (N = 120), age ≥30 years selected by simple random sampling was included in the study. The intervention consisted of a health education programme on the portion sizes of common food items including fruits and vegetables. A self-administered questionnaire was used to collect information on personal and sociodemographic details. Self-regulation on eating was assessed using the Self-Regulation of Eating Behaviour Questionnaire (SREBQ). Results: The mean age of the study participants was 27 ± 5 years. Most of the participants were males, i.e., 72 (60%). Of the total, 55 (47.8%) participants were obese and 18 (15.7%) were overweight. The median number of meals and snacks consumed by the participants was 3 (1–3) and 1 (1–2), respectively. The median (interquartile range [IQR]) knowledge scores of the food portion size significantly increased from 9 (0–16) to 14 (5–19) (P < 0.05). Conclusions: This study has demonstrated that an educational intervention in the workplace setting is feasible and effective in increasing the knowledge of food portion size over a short term.
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Affiliation(s)
- Gopika Vinayachandran
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Namita Patel
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Vijayageetha Mathavaswami
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - L Subitha
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
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Purkiewicz A, Kamelska-Sadowska AM, Ciborska J, Mikulska J, Pietrzak-Fiećko R. Risk Factors for Eating Disorders and Perception of Body in Young Adults Associated with Sex. Nutrients 2021; 13:nu13082819. [PMID: 34444979 PMCID: PMC8401797 DOI: 10.3390/nu13082819] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 08/13/2021] [Accepted: 08/14/2021] [Indexed: 02/06/2023] Open
Abstract
(1) Background: The integrated approach to the prevention and treatment of eating disorders (EDs) requires knowledge and can be used only when specific risk factors are known. The aim of this study was to examine the differences in food choices and eating behavior between males and females; (2) Methods: This study comprised 148 females and 27 males aged from 18 to 26-years-old (MEAN ± SD = 21.4 ± 1.86 years old). Information about EDs was obtained from four different measures: the body mass index (BMI), the eating disorder screen for primary care (ESP), a standardized and validated questionnaire called “My Eating Habits” and the food frequency questionnaire with 10 answers (FFQ-10); (3) Results: The risk for developing eating disorders was detected in nearly 67% of respondents. It was also shown that EDs were more common in females and how body weight affected the way individuals feel about themselves. Females showed more unhealthy eating habits, which contributed to dietary restrictions and emotional overeating, as they were also afraid of gaining weight. The frequency of eating meat and drinking alcohol was higher in males, whereas eating legume seeds was less frequent in females. (4) Conclusions: This study opens a new field, which will help health care professionals recognize the problems with eating disorders and treat them based on different sex characteristics.
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Affiliation(s)
- Aleksandra Purkiewicz
- Department of Commodity Sciences and Food Research, Faculty of Food Science, University of Warmia and Mazury in Olsztyn, Plac Cieszyński 1, 10-719 Olsztyn, Poland; (A.P.); (R.P.-F.)
| | - Anna Malwina Kamelska-Sadowska
- Department of Rehabilitation and Orthopedics, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, 10-719 Olsztyn, Poland
- Clinic of Rehabilitation, Provincial Specialist Children’s Hospital in Olsztyn, 10-719 Olsztyn, Poland
- Correspondence:
| | - Joanna Ciborska
- Department of Human Nutrition, Faculty of Food Science, University of Warmia and Mazury in Olsztyn, Słoneczna 45 F, 10-719 Olsztyn, Poland;
| | - Julia Mikulska
- Cosmetology, Trichology, Dietetics Julia Mikulska, 11-500 Giżycko, Poland;
| | - Renata Pietrzak-Fiećko
- Department of Commodity Sciences and Food Research, Faculty of Food Science, University of Warmia and Mazury in Olsztyn, Plac Cieszyński 1, 10-719 Olsztyn, Poland; (A.P.); (R.P.-F.)
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Johnston R, Norman J, Furber S, Parkinson J. The barriers and enablers to implementing the NSW Healthy School Canteen Strategy in secondary schools in the Illawarra and Shoalhaven region - A qualitative study. Health Promot J Austr 2021; 33:686-695. [PMID: 34382275 DOI: 10.1002/hpja.528] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 07/20/2021] [Accepted: 08/08/2021] [Indexed: 11/11/2022] Open
Abstract
ISSUE ADDRESSED In 2017, the New South Wales Healthy School Canteen Strategy (Strategy) was introduced into primary and secondary schools. Studies have reported that secondary schools have a lower level of compliance with healthy canteen policies compared with primary schools. This study aims to identify and describe the barriers and enablers to implementing the Strategy in Department of Education (DoE) secondary schools in the Illawarra and Shoalhaven regions. METHODS The framework underpinning the study was the systems theory. Canteen managers (CM) and principals from the 21 DoE secondary schools in the Illawarra and Shoalhaven regions were invited to participate in semi-structured interviews. The interviews were structured around the five focus areas of the Strategy, including questions on school nutrition policies and the role of the canteen. Data were collated using the interview guides as a framework and qualitative content analysis, using manual coding, was undertaken. RESULTS Eight (38%) schools participated with seven CMs and six principals interviewed. Barriers to implementing the Strategy included the changing role of the canteen, the increased demands placed on CMs and inconsistencies between the school food environment and the Strategy. Enablers included monitoring implementation, and internal and external support. This study also recognised that previously identified barriers to healthy canteen strategy implementation are ongoing. CONCLUSIONS The school canteen is an integral part of the school environment and therefore needs whole-of-school support if successful implementation of the Strategy is to occur. SO WHAT Addressing the barriers and promoting the enablers identified in this study will support better nutrition policy implementation in secondary schools.
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Affiliation(s)
- Rosi Johnston
- Health Promotion Service, Illawarra Shoalhaven Local Health District, Warrawong, NSW, 2502, Australia
| | - Jennifer Norman
- Health Promotion Service, Illawarra Shoalhaven Local Health District, Warrawong, NSW, 2502, Australia.,Illawarra Health and Medical Research Institute, Wollongong, NSW, 2522, Australia.,Early Start, University of Wollongong, NSW, 2522, Australia
| | - Susan Furber
- Health Promotion Service, Illawarra Shoalhaven Local Health District, Warrawong, NSW, 2502, Australia.,Illawarra Health and Medical Research Institute, Wollongong, NSW, 2522, Australia.,Early Start, University of Wollongong, NSW, 2522, Australia
| | - Julie Parkinson
- Health Promotion Service, Illawarra Shoalhaven Local Health District, Warrawong, NSW, 2502, Australia
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Dörsam AF, Weiland A, Sauer H, Giel KE, Stroebele-Benschop N, Zipfel S, Enck P, Mack I. The Role of Dishware Size in the Perception of Portion Size in Children and Adolescents with Obesity. Nutrients 2021; 13:nu13062062. [PMID: 34208625 PMCID: PMC8235649 DOI: 10.3390/nu13062062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 06/02/2021] [Accepted: 06/11/2021] [Indexed: 11/16/2022] Open
Abstract
Purpose: The influence of dishware on portion size perception in children and adolescents is inconclusive. This study investigated how children and adolescents with both obesity and a normal weight perceived portion size in different sized and shaped dishware items. Methods: The study included 60 children and adolescents with overweight and obesity (OBE) and 27 children and adolescents with normal weight (NW) aged from 9 to 17 years. The participants estimated quantities in three pairs of drinking glasses, one pair of bowls and two pairs of plates which varied in size and shape. The children were instructed to state intuitively which portion they would choose for big or small thirst/hunger. Thereafter they were asked to determine the exact amount by answering which dishware item contained the larger/smaller portion (cognitive evaluation). Results: There were no substantial differences in the intuitive evaluation of portion sizes between OBE and NW. During the cognitive evaluation, OBE estimated the amount of water in the glasses more correctly compared to NW (61% vs. 43%; p = 0.008); OBE estimated the amount of lentils in the bowls and on the plates significantly less correctly (39%) compared to NW (56%; p = 0.013). Conclusions: Habit formation and environmental stimuli might play a greater role in estimating food amounts in dishware than the child’s and adolescent’s body weight.
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Affiliation(s)
- Annica Franziska Dörsam
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, 72076 Tübingen, Germany; (A.F.D.); (A.W.); (H.S.); (K.E.G.); (S.Z.); (P.E.)
| | - Alisa Weiland
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, 72076 Tübingen, Germany; (A.F.D.); (A.W.); (H.S.); (K.E.G.); (S.Z.); (P.E.)
| | - Helene Sauer
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, 72076 Tübingen, Germany; (A.F.D.); (A.W.); (H.S.); (K.E.G.); (S.Z.); (P.E.)
| | - Katrin Elisabeth Giel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, 72076 Tübingen, Germany; (A.F.D.); (A.W.); (H.S.); (K.E.G.); (S.Z.); (P.E.)
| | | | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, 72076 Tübingen, Germany; (A.F.D.); (A.W.); (H.S.); (K.E.G.); (S.Z.); (P.E.)
| | - Paul Enck
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, 72076 Tübingen, Germany; (A.F.D.); (A.W.); (H.S.); (K.E.G.); (S.Z.); (P.E.)
| | - Isabelle Mack
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, 72076 Tübingen, Germany; (A.F.D.); (A.W.); (H.S.); (K.E.G.); (S.Z.); (P.E.)
- Correspondence: ; Tel.: +49-7071-29-85614
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Jensen C, Fang K, Grech A, Rangan A. Trends in Sales and Industry Perspectives of Package Sizes of Carbonates and Confectionery Products. Foods 2021; 10:foods10051071. [PMID: 34066111 PMCID: PMC8151470 DOI: 10.3390/foods10051071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/03/2021] [Accepted: 05/07/2021] [Indexed: 11/23/2022] Open
Abstract
Discretionary food package sizes are an important environmental cue that can affect the amount of food consumed. The aim of this study was to determine sales trends and reported food industry perspectives for changing food package sizes of carbonates and confectionery between 2005 and 2019. Changes in package sizes of carbonates and confectionery were investigated in Australia, the USA, Canada, and the UK. Sales data (units per capita and compound annual growth rate between 2005 and 2019) were extracted from the Euromonitor database. Qualitative data (market research reports) on industry perspectives on package size changes were extracted from industry and marketing databases. Carbonate sales data showed increased growth of smaller package sizes (<300 mL) and a decrease in sales of larger package sizes (≥2000 mL) in all four countries. In contrast, confectionery sales data showed no consistent trends across the selected countries. No growth was observed for smaller confectionery package sizes but an increase in growth of larger package sizes (50–99 g, >100 g), including share packages, was observed in Australia. Qualitative data (n = 92 articles) revealed key reasons identified by industry for changes in package size related to consumer health awareness, portion size control, convenience, market growth, and government or industry initiatives. Monitoring of discretionary food package sizes provides additional insights into consumers’ food environment.
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Desai M, Ross MG. Maternal-infant nutrition and development programming of offspring appetite and obesity. Nutr Rev 2021; 78:25-31. [PMID: 33196091 PMCID: PMC7667467 DOI: 10.1093/nutrit/nuaa121] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
In the United States and Mexico, the obesity epidemic represents a significant public health problem. Although obesity is often attributed to a Western-style, high-fat diet and decreased activity, there is now compelling evidence that this, in part, occurs because of the developmental programming effects resulting from exposure to maternal overnutrition. Human and animal studies demonstrate that maternal obesity and high-fat diet result in an increased risk for childhood and adult obesity. The potential programming effects of obesity have been partly attributed to hyperphagia, which occurs as a result of increased appetite with reduced satiety neuropeptides or neurons. However, depending on maternal nutritional status during the nursing period, the programmed hyperphagia and obesity can be exacerbated or prevented in offspring born to obese mothers. The underlying mechanism of this phenomenon likely involves the plasticity of the appetite regulatory center and thus presents an opportunity to modulate feeding and satiety regulation and break the obesity cycle.
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Affiliation(s)
- Mina Desai
- Department of Obstetrics and Gynecology, The Lundquist Institute at Harbor-UCLA Medical Center, Torrance, California, USA; and David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California, USA
| | - Michael G Ross
- Department of Obstetrics and Gynecology, The Lundquist Institute at Harbor-UCLA Medical Center, Torrance, California, USA; and David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California, USA
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27
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Stewart C, Frie K, Piernas C, Jebb SA. Development and Reliability of the Oxford Meat Frequency Questionnaire. Nutrients 2021; 13:922. [PMID: 33809192 PMCID: PMC7999625 DOI: 10.3390/nu13030922] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 03/05/2021] [Accepted: 03/09/2021] [Indexed: 11/16/2022] Open
Abstract
Reliable and valid measurements of meat intake are needed to advance understanding of its health effects and to evaluate interventions to reduce meat consumption. Here, we describe the development and reliability of the Oxford Meat Frequency Questionnaire (MFQ). It asks individuals to report the number of servings of meat and seafood products they consumed in the last 24 h and is administered daily over 7 days. The MFQ combines food portion size data from the UK Food Standards Agency with estimates of meat content in composite dishes from the UK's National Diet and Nutrition Survey. Adults who self-reported to eat meat (n = 129) completed a 3-week web-based test-retest reliability study assessing the MFQ twice, with a wash-out week in the middle. Two-way random intraclass correlation coefficients (ICC) revealed moderate to good agreement on all meat outcomes (total meat ICC = 0.716; minimum-maximum individual components = 0.531-0.680), except for fish and seafood (ICC = 0.257). Participants reported finding the questionnaire easy to use and, on average, completed it in less than 2 min. This new MFQ offers a quick, acceptable, and reliable method to measure changes in an individual's meat intake in a UK population.
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28
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Carins J, Pang B, Willmott T, Knox K, Storr R, Robertson D, Rundle-Thiele S, Pettigrew S. Creating supportive eating places: a systematic review of food service initiatives. Health Promot Int 2021; 36:1368-1392. [PMID: 33538304 DOI: 10.1093/heapro/daaa155] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Obesity and diet-related health problems are complex, multi-factorial issues. Individual food choices are shaped by the wider context, and food environment level change is needed to support individual behaviour change. The food service sector can play an integral role, changing aspects of the food environment and contributing to improved consumer health. This systematic review aimed to analyse food service schemes that aimed to improve consumer health. Ten electronic databases were systematically searched to identify articles, supplemented with checking of reference lists from similar reviews and forward and backward searches to identify articles describing food service sector schemes. Sixteen schemes were identified, documented in 36 articles/reports. The schemes aimed to improve consumer health through one of three approaches-informing, enabling or engineering. In this order, these approaches involved increasing levels of effort from food services, corresponding with decreasing levels of effort for consumers. Half the schemes were informing, relying on an informed consumer to make a healthy choice. Most informing schemes had been evaluated to determine their impact on consumer choice and/or health, the evidence showed these schemes were generally ineffective. The effect of the enabling or engineering schemes on consumer choice and health had not been measured. Instead, evaluations focussed on process or business engagement rather than behavioural change assessments. This review indicates the food sector has the potential to contribute to consumer health through enabling and engineering; however, detailed outcome assessments are needed to draw definitive conclusions.
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Affiliation(s)
- Julia Carins
- Social Marketing @ Griffith, Department of Marketing, Griffith University, 170 Kessels Road, Nathan, Brisbane, Queensland 4111, Australia
| | - Bo Pang
- Social Marketing @ Griffith, Department of Marketing, Griffith University, 170 Kessels Road, Nathan, Brisbane, Queensland 4111, Australia
| | - Taylor Willmott
- Social Marketing @ Griffith, Department of Marketing, Griffith University, 170 Kessels Road, Nathan, Brisbane, Queensland 4111, Australia
| | - Kathy Knox
- Social Marketing @ Griffith, Department of Marketing, Griffith University, 170 Kessels Road, Nathan, Brisbane, Queensland 4111, Australia
| | - Ryan Storr
- Social Marketing @ Griffith, Department of Marketing, Griffith University, 170 Kessels Road, Nathan, Brisbane, Queensland 4111, Australia
| | - Dianne Robertson
- Social Marketing @ Griffith, Department of Marketing, Griffith University, 170 Kessels Road, Nathan, Brisbane, Queensland 4111, Australia
| | - Sharyn Rundle-Thiele
- Social Marketing @ Griffith, Department of Marketing, Griffith University, 170 Kessels Road, Nathan, Brisbane, Queensland 4111, Australia
| | - Simone Pettigrew
- Food Policy Division, George Institute for Global Health, 1 King St, Newtown, Sydney, New South Wales 2042, Australia
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Analysing Credibility of UK Social Media Influencers' Weight-Management Blogs: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17239022. [PMID: 33287374 PMCID: PMC7731114 DOI: 10.3390/ijerph17239022] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 11/22/2020] [Accepted: 12/01/2020] [Indexed: 12/18/2022]
Abstract
Social media influencers (SMI) are individuals with large follower engagement, who can shape the thoughts and dietary behaviours of their audience. Concerns exist surrounding the spread of dietary misinformation by SMI, which may impact negatively on public health, yet no standards currently exist to assess the credibility of their information. This study aimed to evaluate the credibility of key SMI weight management (WM) blogs (n = 9), piloting a pre-prepared credibility checklist. SMI were included if they had a blue-tick verification on ≥2 social media (SM) and an active WM blog. A sample of blog posts were systematically evaluated against thirteen credibility indicators under four themes: ‘transparency’, ‘use of other resources’, ‘trustworthiness and adherence to nutritional criteria’ and ‘bias’. Indicators were yes/no questions to determine an overall credibility percentage for each SMI. The ten most recent meal recipes from each blog were evaluated against Public Health England’s (PHE) calorie targets and the UK ‘traffic light’ food labelling scheme to assess nutritional quality. Percentages ranged from 23–85%, the highest gained by a Registered Nutritionist. SMI blogs may not be credible as WM resources. Given the popularity and impact of SM in the context of overweight, obesity and WM, this study may inform the methodological approach for future research.
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30
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Christensen LD, Averbuch B. Dealing with excess consumption: Moving beyond redeem, replace and reduce. INTERNATIONAL JOURNAL OF FOOD DESIGN 2020. [DOI: 10.1386/ijfd_00012_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Our current consumption patterns cause high levels of CO2 emissions. Encouraging sustainable lifestyle changes is one tool among many to reduce emissions. Looking towards the public health literature, we identify three strategies for dealing with excess consumption: redeem, replace and reduce. We highlight the benefits and challenges that individuals face when employing these strategies. Finally, we present a promising approach to moving beyond individual-level strategies and their challenges.
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31
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Follong BM, Prieto-Rodriguez E, Miller A, Collins CE, Bucher T. Integrating nutrition into the mathematics curriculum in Australian primary schools: protocol for a randomised controlled trial. Nutr J 2020; 19:128. [PMID: 33243231 PMCID: PMC7694306 DOI: 10.1186/s12937-020-00640-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 10/29/2020] [Indexed: 11/18/2022] Open
Abstract
Background Nutrition education programs in schools have been effective in improving children’s knowledge and behaviours related to food and nutrition. However, teachers find it challenging to implement such programs due to overcrowded curricula. Integrating nutrition with core subjects such as mathematics could potentially address time constraints and improve the learning of both. The primary aim of this randomized controlled trial (RCT) is to evaluate the impact of a cross-curricular nutrition and mathematics program on primary school students’ portion size estimation skills. Secondary aims include impact on their nutrition knowledge, attitudes towards mathematics and evaluating the quality of the lessons. Methods Twelve Year 3–4 classes from Catholic schools in New South Wales, Australia will be randomised to intervention (n = 6) or control (n = 6) groups. Teachers in the intervention group will receive a professional development workshop and resources to teach 4–5 lessons on portion size and measurements across 1–4 weeks. Outcome measures include portion size estimation skills, nutrition knowledge and attitudes towards mathematics, with data collected during three school visits (pre-intervention, immediately post-intervention, 4 weeks post-intervention). Additionally, teaching quality will be assessed in both intervention and control groups and process evaluation undertaken using teacher interviews and student focus groups. Discussion This RCT uses an innovative approach to improve both nutrition and mathematics related learning outcomes among primary school children. It has the potential to impact teaching practices regarding integration of nutrition into curricula and enhance the implementation of nutrition education interventions. Trial registration Australian and New Zealand Clinical Trials Register ACTRN12619001071112 31/07/2019.
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Affiliation(s)
- Berit M Follong
- School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Newcastle, NSW, Australia.,Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Newcastle, NSW, Australia.,Priority Research Centre for Health Behaviour, The University of Newcastle, Newcastle, NSW, Australia
| | - Elena Prieto-Rodriguez
- School of Education, Faculty of Education and Arts, The University of Newcastle, Newcastle, NSW, Australia
| | - Andrew Miller
- School of Education, Faculty of Education and Arts, The University of Newcastle, Newcastle, NSW, Australia
| | - Clare E Collins
- School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Newcastle, NSW, Australia.,Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Newcastle, NSW, Australia
| | - Tamara Bucher
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Newcastle, NSW, Australia. .,Priority Research Centre for Health Behaviour, The University of Newcastle, Newcastle, NSW, Australia. .,School of Environmental and Life Sciences, Faculty of Science, The University of Newcastle, 10 Chittaway Road, Ourimbah, NSW, 2258, Australia.
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32
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Robertson DA, Lavin C, Lunn PD. Can Visual Cues to Portion Size Reduce the Number of Portions of Consumed? Two Randomized Controlled Trials. Ann Behav Med 2020; 55:746-757. [DOI: 10.1093/abm/kaaa098] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Abstract
Background
Since 1950, the portion size of many snack foods has more than doubled and obesity rates have tripled. Portion size determines energy intake, often unwittingly.
Purpose
This paper tests whether salient visual cues to portion size on the packaging of high fat, sugar, or salty (HFSS) snacks can reduce consumption.
Methods
Two preregistered randomized controlled trials (N = 253 and N = 674) measured consumption in a lab and the home environment. Cues were salient, labeled stripes that demarcated single portions. Participants were randomized to cue condition or control. Consumption was measured without awareness.
Results
The main preregistered effect of the visual cue was not statistically significant. There was some variation by subgroup. In Study 1, men were more likely to eat the whole can of potato chips than women but significantly reduced consumption when visual cues were on the pack. The effect size was large: the number of men eating more than the recommended portion fell by 33%. Study 2 monitored household consumption of chocolate biscuits (cookies) sent to family homes in gift packs. Again, the main effect was nonsignificant but there was significant subgroup variation. When the person receiving the biscuits was female, households were more likely to eat more than the recommended portion per person per day, but less likely when the visual cues were displayed. The gender of the eaters was not known. The effect size was again large: the number of households eating more than the recommended portion fell by 26%. Households with children were also less likely to open packs with visual cues compared to control packs. Both studies recorded significant increases in the likelihood of observing serving size information, together with confusion about what it means.
Conclusions
The studies offer some evidence that salient visual cues could play a role in tackling the high consumption of unhealthy snacks, but the effects are confined to specific subgroups and warrant further investigation.
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Affiliation(s)
- Deirdre A Robertson
- Behavioural Research Unit, Economic and Social Reserach Institute, Dublin, Ireland
- School of Psychology, Trinity College Dublin, Dublin, Ireland
| | - Ciarán Lavin
- Behavioural Research Unit, Economic and Social Reserach Institute, Dublin, Ireland
| | - Peter D Lunn
- Behavioural Research Unit, Economic and Social Reserach Institute, Dublin, Ireland
- Department of Economics, Trinity College Dublin, Dublin, Ireland
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Chopra S, Malhotra A, Ranjan P, Vikram NK, Singh N. Lifestyle-related advice in the management of obesity: A step-wise approach. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2020; 9:239. [PMID: 33209931 PMCID: PMC7652086 DOI: 10.4103/jehp.jehp_216_20] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 03/21/2020] [Indexed: 06/11/2023]
Abstract
Obesity is a commonly encountered health-care problem that is an independent risk factor for chronic metabolic complications. Primary care physicians are the first point of contact in the management of obesity. Weight management is a step-wise intensification of interventions that initiates with lifestyle modification. Dietary and physical activity advices are integral components of all weight loss consultations and should ideally be imparted by a dietician or a nutritionist. In case of their nonavailability, the onus for lifestyle counseling rests with the physician. The prescription for a low-calorie diet coupled with increased physical activity might seem simple, but the success lies in compliance and sustainability of this advice. Compliance can be enhanced through patient-specific diet and activity plans along with corrections in eating and activity behavior. Barriers in patient's environment must also be addressed to achieve sustainable weight loss. This review covers practical insights in standard lifestyle management techniques, which can help the physicians to set better weight loss goals, adapt to patient specific lifestyle counseling, and apply strategies to enhance compliance for sustained weight loss.
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Affiliation(s)
- Sakshi Chopra
- Department of Home Science, University of Delhi, New Delhi, India
| | - Anita Malhotra
- Department of Home Science, University of Delhi, New Delhi, India
| | | | | | - Namrata Singh
- Department of Gastroenterology and Human Nutrition, AIIMS, New Delhi, India
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Interplay of Dietary Fatty Acids and Cholesterol Impacts Brain Mitochondria and Insulin Action. Nutrients 2020; 12:nu12051518. [PMID: 32456175 PMCID: PMC7284591 DOI: 10.3390/nu12051518] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 05/15/2020] [Accepted: 05/21/2020] [Indexed: 02/06/2023] Open
Abstract
Overconsumption of high-fat and cholesterol-containing diets is detrimental for metabolism and mitochondrial function, causes inflammatory responses and impairs insulin action in peripheral tissues. Dietary fatty acids can enter the brain to mediate the nutritional status, but also to influence neuronal homeostasis. Yet, it is unclear whether cholesterol-containing high-fat diets (HFDs) with different combinations of fatty acids exert metabolic stress and impact mitochondrial function in the brain. To investigate whether cholesterol in combination with different fatty acids impacts neuronal metabolism and mitochondrial function, C57BL/6J mice received different cholesterol-containing diets with either high concentrations of long-chain saturated fatty acids or soybean oil-derived poly-unsaturated fatty acids. In addition, CLU183 neurons were stimulated with combinations of palmitate, linoleic acid and cholesterol to assess their effects on metabolic stress, mitochondrial function and insulin action. The dietary interventions resulted in a molecular signature of metabolic stress in the hypothalamus with decreased expression of occludin and subunits of mitochondrial electron chain complexes, elevated protein carbonylation, as well as c-Jun N-terminal kinase (JNK) activation. Palmitate caused mitochondrial dysfunction, oxidative stress, insulin and insulin-like growth factor-1 (IGF-1) resistance, while cholesterol and linoleic acid did not cause functional alterations. Finally, we defined insulin receptor as a novel negative regulator of metabolically stress-induced JNK activation.
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Jackson SE, Llewellyn CH, Smith L. The obesity epidemic - Nature via nurture: A narrative review of high-income countries. SAGE Open Med 2020; 8:2050312120918265. [PMID: 32435480 PMCID: PMC7222649 DOI: 10.1177/2050312120918265] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 03/04/2020] [Indexed: 12/19/2022] Open
Abstract
Over the last three decades, the prevalence of obesity has increased rapidly in populations around the world. Despite a wealth of research, the relative contributions of the different mechanisms underlying this global epidemic are not fully understood. While there is growing consensus that the rapid rise in obesity prevalence has been driven by changes to the environment, it is evident that biology plays a central role in determining who develops obesity and who remains lean in the current obesogenic environment. This review summarises evidence on the extent to which genes and the environment influence energy intake and energy expenditure, and as a result, contribute to the ongoing global obesity epidemic. The concept of genetic susceptibility to the environment driving human variation in body weight is discussed.
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Affiliation(s)
- Sarah E Jackson
- Department of Behavioural Science and Health, University College London, London, UK
- Sarah E Jackson, Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK.
| | - Clare H Llewellyn
- Department of Behavioural Science and Health, University College London, London, UK
| | - Lee Smith
- Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
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36
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Venema TAG, Kroese FM, Verplanken B, de Ridder DTD. The (bitter) sweet taste of nudge effectiveness: The role of habits in a portion size nudge, a proof of concept study. Appetite 2020; 151:104699. [PMID: 32277952 DOI: 10.1016/j.appet.2020.104699] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 03/02/2020] [Accepted: 04/04/2020] [Indexed: 10/24/2022]
Abstract
Seemingly insignificant daily practices, such as sugar usage in tea, can have a great accumulated impact on societal issues, such as obesity. That is why these behaviours are often the target of nudge interventions. However, when these behaviours are performed frequently they may turn into habits that are difficult to change. The aim of the current study was to investigate whether a portion size nudge has the potential to work in accordance with (instead of against) existing habits. Specifically, it was tested whether a portion size nudge would be more effective in reducing the amount of sugar added to tea, when people have a strong habit of adding a fixed amount of teaspoons of sugar to a cup of tea. The study (N = 123) had a mixed factorial design with teaspoon size (reduced size vs. control) as a within-subject factor, and habit disruption context condition (hot tea vs. cold tea) as a between-subjects factor. A paired t-test indicated that this nudge reduced sugar intake on average by 27% within subjects. When the context allowed for automatic enactment of the habit, the effectiveness of this nudge was moderated by habit strength. Surprisingly, the nudge effect was actually less pronounced when people had a strong habit. Implications for effective nudge interventions are discussed.
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Affiliation(s)
- Tina A G Venema
- Utrecht University, Social Health and Organizational Psychology, 3508 TC, Utrecht, the Netherlands; Aarhus University, Department of Psychology and Behavioural Sciences, Denmark.
| | - Floor M Kroese
- Utrecht University, Social Health and Organizational Psychology, 3508 TC, Utrecht, the Netherlands
| | - Bas Verplanken
- Bath University, Department of Psychology, Bath, BA2 7AY, UK
| | - Denise T D de Ridder
- Utrecht University, Social Health and Organizational Psychology, 3508 TC, Utrecht, the Netherlands
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Tang T, Wang W, Croden F, Vazirian M, Hetherington MM. “Wrap healthy snacks with cool packaging” - A qualitative study of mothers’ portion size strategies for their children. Appetite 2020; 147:104537. [DOI: 10.1016/j.appet.2019.104537] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 10/23/2019] [Accepted: 11/21/2019] [Indexed: 11/29/2022]
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38
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Reinders MJ, van Lieshout L, Pot GK, Neufingerl N, van den Broek E, Battjes-Fries M, Heijnen J. Portioning meat and vegetables in four different out of home settings: A win-win for guests, chefs and the planet. Appetite 2020; 147:104539. [DOI: 10.1016/j.appet.2019.104539] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 10/25/2019] [Accepted: 11/23/2019] [Indexed: 01/21/2023]
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39
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Comparison of the eating behaviour and dietary consumption in older adults with and without visual impairment. Br J Nutr 2020; 123:712-720. [PMID: 31791430 DOI: 10.1017/s000711451900312x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Globally, a high prevalence of obesity and undernutrition has been reported in people with visual impairment (VI) who have reported multi-factorial obstacles that prevent them from achieving a healthy diet, such as having restricted shopping and cooking abilities. The present study is the first to investigate the relationship between VI and dietary consumption using a representative sample size, standardised methods to categorise VI and a detailed analysis of dietary consumption. Ninety-six participants with VI and an age-matched control group of fifty participants were recruited from across the UK. All participants were aged 50 years or over. The participants completed a 24-h food recall for a period of 3 d. The participants also answered questions about their abilities to shop for and cook food as well as their knowledge of healthy eating. The participants with VI in this sample consumed significantly fewer energy content and other nutrients than is recommended for their age group and when compared with an age-matched control group. The participants with VI mainly made food choices irrespective of nutritional value. The results of the present study highlight for the first time that a large proportion of older adults with VI in the UK are undernourished. These results suggest local and government-led initiatives should be implemented to support the diets of older adults in the UK, and these initiatives could include healthy eating workshops, café clubs or skills training and rehabilitation.
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Haynes A, Hardman CA, Halford JCG, Jebb SA, Mead BR, Robinson E. Reductions to main meal portion sizes reduce daily energy intake regardless of perceived normality of portion size: a 5 day cross-over laboratory experiment. Int J Behav Nutr Phys Act 2020; 17:21. [PMID: 32050979 PMCID: PMC7017560 DOI: 10.1186/s12966-020-0920-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 01/23/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Smaller portions may help to reduce energy intake. However, there may be a limit to the magnitude of the portion size reduction that can be made before consumers respond by increasing intake of other food immediately or at later meals. We tested the theoretical prediction that reductions to portion size would result in a significant reduction to daily energy intake when the resulting portion was visually perceived as 'normal' in size, but that a reduction resulting in a 'smaller than normal' portion size would cause immediate or later additional eating. METHODS Over three 5-day periods, daily energy intake was measured in a controlled laboratory study using a randomized crossover design (N = 30). The served portion size of the main meal component of lunch and dinner was manipulated in three conditions: 'large-normal' (747 kcal), 'small-normal' (543 kcal), and 'smaller than normal' (339 kcal). Perceived 'normality' of portion sizes was determined by two pilot studies. Ad libitum daily energy intake from all meals and snacks was measured. RESULTS Daily energy intake in the 'large-normal' condition was 2543 kcals. Daily energy intake was significantly lower in the 'small-normal' portion size condition (mean difference - 95 kcal/d, 95% CI [- 184, - 6], p = .04); and was also significantly lower in the 'smaller than normal' than the 'small-normal' condition (mean difference - 210 kcal/d, 95% CI [- 309, - 111], p < .001). Contrary to predictions, there was no evidence that the degree of additional food consumption observed was greater when portions were reduced past the point of appearing normal in size. CONCLUSIONS Reductions to the portion size of main-meal foods resulted in significant decreases in daily energy intake. Additional food consumption did not offset this effect, even when portions were reduced to the point that they were no longer perceived as being normal in size. TRIAL REGISTRATION Prospectively registered protocol and analysis plan: https://osf.io/natws/; retrospectively registered: https://clinicaltrials.gov/ct2/show/NCT03811210.
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Affiliation(s)
- Ashleigh Haynes
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, VIC 3004, Melbourne, Australia.
| | - Charlotte A Hardman
- Department of Psychological Sciences, University of Liverpool, L69 7ZA, Liverpool, UK
| | - Jason C G Halford
- Department of Psychological Sciences, University of Liverpool, L69 7ZA, Liverpool, UK
| | - Susan A Jebb
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, England
| | - Bethan R Mead
- Department of Psychological Sciences, University of Liverpool, L69 7ZA, Liverpool, UK
| | - Eric Robinson
- Department of Psychological Sciences, University of Liverpool, L69 7ZA, Liverpool, UK.
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Portion size normality and additional within-meal food intake: two crossover laboratory experiments. Br J Nutr 2019; 123:462-471. [PMID: 31488225 DOI: 10.1017/s0007114519002307] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Reducing food portion size could reduce energy intake. However, it is unclear at what point consumers respond to reductions by increasing intake of other foods. We predicted that a change in served portion size would only result in significant additional eating within the same meal if the resulting portion size was no longer visually perceived as 'normal'. Participants in two crossover experiments (Study 1: n 45; Study 2: n 37; adults, 51 % female) were served different-sized lunchtime portions on three occasions that were perceived by a previous sample of participants as 'large-normal', 'small-normal' and 'smaller than normal', respectively. Participants were able to serve themselves additional helpings of the same food (Study 1) or dessert items (Study 2). In Study 1 there was a small but significant increase in additional intake when participants were served the 'smaller than normal' compared with the 'small-normal' portion (m difference = 161 kJ, P = 0·002, d = 0·35), but there was no significant difference between the 'small-normal' and 'large-normal' conditions (m difference = 88 kJ, P = 0·08, d = 0·24). A similar pattern was observed in Study 2 (m difference = 149 kJ, P = 0·06, d = 0·18; m difference = 83 kJ, P = 0·26, d = 0·10). However, smaller portion sizes were each associated with a significant reduction in total meal intake. The findings provide preliminary evidence that reductions that result in portions appearing 'normal' in size may limit additional eating, but confirmatory research is needed.
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Almiron-Roig E, Forde CG, Hollands GJ, Vargas MÁ, Brunstrom JM. A review of evidence supporting current strategies, challenges, and opportunities to reduce portion sizes. Nutr Rev 2019; 78:91-114. [DOI: 10.1093/nutrit/nuz047] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
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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Affiliation(s)
- Eva Almiron-Roig
- E. Almiron-Roig and M. Ángeles Vargas are with the Centre for Nutrition Research, University of Navarra, Pamplona, Spain
- E. Almiron-Roig is with the Navarra Institute for Health Research (IdiSNa), Pamplona, Spain
| | - Ciaran G Forde
- C.G. Forde is with the Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Singapore
| | - Gareth J Hollands
- G.J. Hollands is with the Behaviour and Health Research Unit, University of Cambridge, Cambridge, United Kingdom
| | - M Ángeles Vargas
- E. Almiron-Roig and M. Ángeles Vargas are with the Centre for Nutrition Research, University of Navarra, Pamplona, Spain
| | - Jeffrey M Brunstrom
- J.M. Brunstrom is with the Nutrition and Behaviour Unit, School of Psychological Science, and the National Institute for Health Research, Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust, University of Bristol, Bristol, United Kingdom
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Kosīte D, König LM, De-loyde K, Lee I, Pechey E, Clarke N, Maynard O, Morris RW, Munafò MR, Marteau TM, Fletcher PC, Hollands GJ. Plate size and food consumption: a pre-registered experimental study in a general population sample. Int J Behav Nutr Phys Act 2019; 16:75. [PMID: 31462252 PMCID: PMC6714429 DOI: 10.1186/s12966-019-0826-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 07/26/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is considerable uncertainty regarding the impact of tableware size on food consumption. Most existing studies have used small and unrepresentative samples and have not followed recommended procedures for randomised controlled trials, leading to increased risk of bias. In the first pre-registered study to date, we examined the impact on consumption of using larger versus smaller plates for self-served food. We also assessed impact on the underlying meal micro-structure, such as number of servings and eating rate, which has not previously been studied. METHODS The setting was a purpose-built naturalistic eating behaviour laboratory. A general population sample of 134 adult participants (aged 18-61 years) was randomly allocated to one of two groups varying in the size of plate used for self-serving lunch: large or small. The primary outcome was amount of food energy (kcal) consumed during a meal. Additionally, we assessed impact on meal micro-structure, and examined potential modifying effects of executive function, socio-economic position, and sensitivity to perceptual cues. RESULTS There was no clear evidence of a difference in consumption between the two groups: Cohen's d = 0.07 (95% CI [- 0.27, 0.41]), with participants in the large plate group consuming on average 19.2 (95% CI [- 76.5, 115.0]) more calories (3%) compared to the small plate group (large: mean (SD) = 644.1 (265.0) kcal, versus small: 624.9 (292.3) kcal). The difference between the groups was not modified by individual characteristics. There was no evidence of impact on meal micro-structure, with the exception of more food being left on the plate when larger plates were used. CONCLUSIONS This study suggests that previous meta-analyses of a low-quality body of evidence may have considerably overestimated the effects of plate size on consumption. However, the possibility of a clinically significant effect - in either direction - cannot be excluded. Well-conducted trials of tableware size in real-world field settings are now needed to determine whether changing the size of tableware has potential to contribute to efforts to reduce consumption at population-level. TRIAL REGISTRATION The study protocol ( https://osf.io/e3dfh/ ) and data analysis plan ( https://osf.io/sh5u7/ ) were pre-registered on the Open Science Framework.
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Affiliation(s)
- Daina Kosīte
- Behaviour and Health Research Unit, University of Cambridge, Cambridge, UK
| | - Laura M. König
- Behaviour and Health Research Unit, University of Cambridge, Cambridge, UK
- Department of Psychology, University of Konstanz, Constance, Germany
| | - Katie De-loyde
- UK Centre for Tobacco and Alcohol Studies, School of Psychological Science, University of Bristol, Bristol, UK
| | - Ilse Lee
- Behaviour and Health Research Unit, University of Cambridge, Cambridge, UK
| | - Emily Pechey
- Behaviour and Health Research Unit, University of Cambridge, Cambridge, UK
| | - Natasha Clarke
- Behaviour and Health Research Unit, University of Cambridge, Cambridge, UK
| | - Olivia Maynard
- UK Centre for Tobacco and Alcohol Studies, School of Psychological Science, University of Bristol, Bristol, UK
| | - Richard W. Morris
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Marcus R. Munafò
- UK Centre for Tobacco and Alcohol Studies, School of Psychological Science, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit (IEU), UK Centre for Tobacco and Alcohol Studies, School of Experimental Psychology, University of Bristol, Bristol, UK
| | - Theresa M. Marteau
- Behaviour and Health Research Unit, University of Cambridge, Cambridge, UK
| | - Paul C. Fletcher
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Gareth J. Hollands
- Behaviour and Health Research Unit, University of Cambridge, Cambridge, UK
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Policastro P, Harris C, Chapman G. Tasting with your eyes: Sensory description substitutes for portion size. Appetite 2019; 139:42-49. [PMID: 30995490 DOI: 10.1016/j.appet.2019.04.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2018] [Revised: 03/25/2019] [Accepted: 04/10/2019] [Indexed: 10/27/2022]
Abstract
A field study conducted in a diner explored whether a sensory rich description of an indulgent dessert prompts consumers to be willing to pay just as much for a small serving as for a large serving. Diner customers (N = 809) who ordered an entrée received a free piece of chocolate cake if they filled out a questionnaire indicating the amount of cake they ate, their willingness to pay (WTP) for the cake, their fullness after eating, and other measures. A between-subjects 2 × 3 design varied the serving size of the cake (6 oz. vs. 12 oz.) and the description of the cake (no description control, nutrition description, or sensory description). Self-reported amount eaten showed a smaller portion size effect in the nutrition description condition than in the other two conditions. Of primary interest, relative to the other conditions, the sensory description caused customers to be willing to pay as much for the small piece as for the large piece and to feel almost as full after eating from the small piece as from the large piece. These results indicate that a sensory rich description makes customers' evaluations of an indulgent dessert less sensitive to serving size. As a result, sensory descriptions can be used to make customers just as content with a small dessert as they would be with a large dessert.
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Affiliation(s)
- Peggy Policastro
- Institute for Food, Nutrition, & Health, Rutgers University, USA.
| | - Carly Harris
- Institute for Food, Nutrition, & Health, Rutgers University, USA
| | - Gretchen Chapman
- Department of Social & Decision Sciences, Carnegie Mellon University, USA
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Chao AM, Wadden TA, Walsh OA, Gruber KA, Alamuddin N, Berkowitz RI, Shaw Tronieri J. Perceptions of a large amount of food based on binge-eating disorder diagnosis. Int J Eat Disord 2019; 52:801-808. [PMID: 30927476 PMCID: PMC6609473 DOI: 10.1002/eat.23076] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 03/11/2019] [Accepted: 03/11/2019] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This study examined what adults with binge-eating disorder (BED) and obesity perceived as the threshold for a large amount of food and how their evaluations compared to ratings by participants with obesity but without BED. METHOD This was a cross-sectional study of 150 participants with obesity. BED was assessed using the Questionnaire on Eating and Weight Patterns and confirmed via interview. Participants completed the Eating Patterns Questionnaire and Eating Inventory. RESULTS Participants with BED had significantly higher thresholds for a large amount of food relative to those without BED. Compared to participants without BED, those with BED had significantly higher thresholds on 13 of the 22 food items. In the overall sample, being male and having higher hunger scores were associated with greater thresholds. DISCUSSION Individuals with obesity and BED had larger portion standards than participants without BED. Individuals with BED may benefit from interventions targeted toward decreasing perceptions of portion sizes.
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Affiliation(s)
- Ariana M. Chao
- University of Pennsylvania School of Nursing, Department of Biobehavioral Health Sciences, Philadelphia, PA, USA;,Perelman School of Medicine at the University of Pennsylvania, Department of Psychiatry, Philadelphia, PA, USA
| | - Thomas A. Wadden
- Perelman School of Medicine at the University of Pennsylvania, Department of Psychiatry, Philadelphia, PA, USA
| | - Olivia A. Walsh
- Perelman School of Medicine at the University of Pennsylvania, Department of Psychiatry, Philadelphia, PA, USA
| | - Kathryn A. Gruber
- Perelman School of Medicine at the University of Pennsylvania, Department of Psychiatry, Philadelphia, PA, USA
| | - Naji Alamuddin
- Perelman School of Medicine at the University of Pennsylvania, Department of Psychiatry, Philadelphia, PA, USA
| | - Robert I. Berkowitz
- Perelman School of Medicine at the University of Pennsylvania, Department of Psychiatry, Philadelphia, PA, USA;,Children’s Hospital of Philadelphia, Department of Child and Adolescent Psychiatry and Behavioral Science, Philadelphia, PA, USA
| | - Jena Shaw Tronieri
- Perelman School of Medicine at the University of Pennsylvania, Department of Psychiatry, Philadelphia, PA, USA
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Plessz M, Kesse-Guyot E, Zins M, Matta J, Czernichow S. Poverty does not modify the association between perceived diet healthiness and adherence to nutritional guidelines in the Constances cohort (France). Appetite 2019; 138:190-197. [PMID: 30928517 DOI: 10.1016/j.appet.2019.03.028] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 03/04/2019] [Accepted: 03/23/2019] [Indexed: 10/27/2022]
Abstract
Poor individuals have less healthy diets and seem to benefit less from nutrition information campaigns. One may wonder if they are less aware of their diets' shortcomings. The aim of this paper is to assess whether the association between perceived diet healthiness and adherence to nutritional guidelines is weaker among poor people. Data were collected from 40,000 participants from the Constances study, a large population-based observational cohort in France. Adherence to French nutritional guidelines was measured by a validated score based on a 22 item food frequency questionnaire and poverty was defined as facing material deprivation. These variables and their interaction were the variables of interest of a linear regression predicting perceived diet healthiness, with controls for confounders and 95% CI. Poor participants had lower nutrition scores and diet healthiness perceptions. Among respondents who had never faced material deprivation, for each increase in the guideline adherence score there was a +0.21 change (95% CI [0.18,0.23]) in perceived diet healthiness for men (women: +0.19 [0.17,0.22]). The coefficients were not smaller among poor respondents. Our results do not support the assumption that people facing poverty might overestimate their diet healthiness. This suggests that information campaigns are not enough: policies or interventions making healthy eating easier and more manageable are necessary.
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Affiliation(s)
- Marie Plessz
- INRA, Centre Maurice Halbwachs (CNRS, ENS, EHESS, PSL), 48 bd Brandebourg, 75014 Paris, France.
| | - Emmanuelle Kesse-Guyot
- Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), Inserm U1153, Inra U1125, Cnam, Paris 13 University, Nutritional Epidemiology Research Team (EREN), F-93017, Bobigny, France.
| | - Marie Zins
- UMS 011 Cohortes épidémiologiques en population, Hôpital Paul Brousse, 16, ave. Paul Vaillant Couturier, 94807, Villejuif, France.
| | - Joane Matta
- UMS 011 Cohortes épidémiologiques en population, Hôpital Paul Brousse, 16, ave. Paul Vaillant Couturier, 94807, Villejuif, France.
| | - Sébastien Czernichow
- APHP, Department of Nutrition, Georges Pompidou European Hospital, Paris, France; Inserm, UMR 1153 Epidemiology and Biostatistics Sorbonne Paris Cité Centre (CRESS), METHODS Team, 75004 Paris, France; Paris Descartes University, Paris, France.
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Barata‐Cavalcanti O, Ty D, Novelli W, Costa S, Huang TT. Informing a roadmap for cross-sectoral collaboration on portion size management as a national strategy to improve population nutrition - a Delphi study. Obes Sci Pract 2019; 5:189-202. [PMID: 31275593 PMCID: PMC6587328 DOI: 10.1002/osp4.331] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Revised: 01/17/2019] [Accepted: 01/18/2019] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Addressing food portion sizes is a key untapped opportunity to help tackle obesity. This study sought to inform the agenda of a national movement involving diverse sectors to manage portion sizes in packaged foods, restaurants, cafeterias and prepared foods in grocery stores. METHODS A Delphi study was conducted with representatives from public health, private-sector food companies and academia that formed a panel of experts (n = 32). Three iterative rounds of surveys were administered over 3 months. The surveys gathered opinions on psychological mindsets affecting portion size choice, eating habits, portion perception and distortion, passive overconsumption and challenges and advantages of this tool to improve population nutrition. The survey also inquired about visions for a future food environment. After every round, responses were analysed and questions narrowed to reach group consensus on specific items in the subsequent round. RESULTS Although many experts fear that portion size interventions might be perceived as paternalistic, 91% of respondents agreed stealth interventions were preferable. Seventy-three per cent of experts believed that the most impactful portion size intervention was product reformulation while smaller packages were the most effective intervention according to only 28% of experts. The majority of the panel (59%) also believed that creating an artificial stopping point in packages was the best strategy to reduce food consumption. Finally, the study found that one of the most complex aspects of establishing a multi-sector collaboration for obesity prevention was to ascertain trust in the private sector's ability to balance profit versus social responsibility.[Corrections added on 21 March 2019, after first online publication: The percentage of experts who believed that small packages were the most effective intervention has been changed from "16%" to "28%".]. CONCLUSION This study informs the agenda of a cross-sectoral, coordinated movement to tackle obesity through a combination of changing social norms, individual behaviours and industry practices around portion size. Although cross-sectoral collaboration for non-communicable disease prevention is encouraged by different organizations, strategic efforts to define a common agenda on portion size have been limited thus far. This research highlights important strategies in portion size interventions and steps needed for the success of such a movement, as part of a wider effort across sectors and stakeholders to halt and reverse obesity rates in the USA.
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Affiliation(s)
- O. Barata‐Cavalcanti
- Center for Systems and Community Design, Graduate School of Public Health and Health PolicyCity University of New YorkNew YorkNYUSA
| | - D. Ty
- Global Social Enterprise Initiative, McDonough School of BusinessGeorgetown UniversityWashingtonDCUSA
| | - W. Novelli
- Global Social Enterprise Initiative, McDonough School of BusinessGeorgetown UniversityWashingtonDCUSA
| | - S. Costa
- Center for Systems and Community Design, Graduate School of Public Health and Health PolicyCity University of New YorkNew YorkNYUSA
| | - T. T.‐K. Huang
- Center for Systems and Community Design, Graduate School of Public Health and Health PolicyCity University of New YorkNew YorkNYUSA
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Fast-Food Offerings in the United States in 1986, 1991, and 2016 Show Large Increases in Food Variety, Portion Size, Dietary Energy, and Selected Micronutrients. J Acad Nutr Diet 2019; 119:923-933. [DOI: 10.1016/j.jand.2018.12.004] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Accepted: 12/11/2018] [Indexed: 01/26/2023]
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Ferrar J, Ferriday D, Smit HJ, McCaig DC, Rogers PJ. Identifying Barriers to Reducing Portion Size: A Qualitative Focus Group Study of British Men and Women. Nutrients 2019; 11:nu11051054. [PMID: 31083447 PMCID: PMC6567109 DOI: 10.3390/nu11051054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 05/03/2019] [Accepted: 05/06/2019] [Indexed: 02/06/2023] Open
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.
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Affiliation(s)
- Jennifer Ferrar
- Nutrition and Behaviour Unit, School of Psychological Science, University of Bristol, 12a Priory Road, Bristol BS8 1TU, UK.
| | - Danielle Ferriday
- Nutrition and Behaviour Unit, School of Psychological Science, University of Bristol, 12a Priory Road, Bristol BS8 1TU, UK.
| | - Hendrik J Smit
- Nutrition and Behaviour Unit, School of Psychological Science, University of Bristol, 12a Priory Road, Bristol BS8 1TU, UK.
| | - Duncan C McCaig
- Nutrition and Behaviour Unit, School of Psychological Science, University of Bristol, 12a Priory Road, Bristol BS8 1TU, UK.
| | - Peter J Rogers
- Nutrition and Behaviour Unit, School of Psychological Science, University of Bristol, 12a Priory Road, Bristol BS8 1TU, UK.
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust, University of Bristol, Bristol BS2 8AE, UK.
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50
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Brown HM, Collins CE, Bucher T, Rollo ME. Evaluation of the effectiveness and usability of an educational portion size tool, ServARpreg, for pregnant women. J Hum Nutr Diet 2019; 32:719-727. [PMID: 31020739 DOI: 10.1111/jhn.12660] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND Elevated blood glucose levels in pregnancy increases the risk of adverse pregnancy outcomes. Modifying consumption of carbohydrate-rich foods is important for blood glucose regulation; however, the tools commonly used to assist in guiding portion control are impractical. The present study aimed to evaluate usability of ServARpreg, a mobile phone-based nutrition tool, and its effectiveness with respect to improving carbohydrate and standard serve size knowledge in pregnant women. METHODS A baseline survey assessed knowledge of carbohydrates and standard serve sizes of pregnant women. A subset of women living in Newcastle were invited to use ServARpreg, containing pregnancy nutrition information and augmented reality guidance on portion control. A follow-up survey was sent to all women 4 weeks after baseline and women who received ServARpreg also received a process evaluation survey after 10 weeks. RESULTS Responses were received from 186 pregnant women for the baseline survey, with 97 completing the follow-up (52.2%). Of the 56 women eligible to receive ServARpreg in the sub-study, 47 accepted (83.9%) and, of these, 40 completed the process evaluation survey (85.1%). At follow-up, there was a significant group × time interaction in favour of the ServARpreg group for carbohydrate quantification knowledge (F1,279 = 9.705, P = 0.002). Standard serve size knowledge did not change between groups. In the process evaluation survey, 80% strongly agreed/agreed that ServARpreg made them more aware of how much they ate and 72.5% found ServARpreg easy to use. CONCLUSIONS ServARpreg has shown potential to educate pregnant women about carbohydrate quantification and increase portion size awareness. Further refinement of the tool and evaluation is needed to improve standard serve size knowledge.
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Affiliation(s)
- H M Brown
- School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW, Australia
| | - C E Collins
- School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW, Australia
| | - T Bucher
- School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW, Australia
| | - M E Rollo
- School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW, Australia
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