Food portion sizes and their relationship with energy, and nutrient intakes in adolescents: The HELENA study.

OBJECTIVES: This study aimed to investigate the associations between portion sizes (PSs) from different food groups and energy, as well as nutrient intakes in European adolescents. METHODS: A sample of 1631 adolescents (54.2 % girls) were included from the Healthy Lifestyle in Europe by Nutrition in Adolescence Cross-Sectional (HELENA) study. Mean food PS was calculated by dividing the total intake of the items by the number of eating occasions of these consumed items. To determine the key items for analysis, foods were ranked by frequency of consumption. A one-way between-groups analysis of covariance was used to test for significant differences in means across tertiles. A multivariable linear regression analysis was carried out, adjusting for age, sex, maternal education, body mass index, and using country as a level. RESULTS: Energy intake increased with elevated intakes of energy-dense foods. Large portions of rice and other grains, starch roots and potatoes, and meat substitutes, nuts, and pulses were associated with increased carbohydrate and fiber intake. Larger portions of cheese and butter and animal fat were significantly associated with a higher fat intake. Lower intakes of some vitamins and micronutrients were noticed with consumption of larger portions of high energy-dense foods, such as desserts and pudding, margarine and vegetable oil, and butter and animal fat. CONCLUSIONS: Large food PSs may be associated with positive energy, as well as macro- and micronutrient intake. Moreover, the findings from this study may help the future development of dietary guidance in general and specific to PSs, and support targeted strategies to address intakes of certain nutrients in European adolescents.

The Association between Portion Sizes from High-Energy-Dense Foods and Body Composition in European Adolescents: The HELENA Study.

Obesity prevalence has been simultaneously increasing with high consumption of large food portion sizes (PS). However, there is scarce information on PS of energy-dense (ED) foods as a potential risk factor of obesity in adolescents. In the present study, we investigate the association between the PS of the most ED foods and body composition. A sample of 1889 adolescents (54.4% females) from the Healthy Lifestyle in Europe by Nutrition in Adolescence cross-sectional multicenter study (HELENA-CSS) study were included. Most ED foods (e.g., cheese) were selected according to higher fat and/or sugar content and low fiber and water. Linear and ordinal logistic regression models were adjusted for age, physical activity, total energy intake (TEI), and socioeconomic status (SES). Analysis was performed both in those adolescents reporting plausible energy intake according to the approach of Goldberg et al. and in the whole sample. In male plausible reporters, PS from "breakfast cereals" showed a significant and positive association with BMI (ß = 0.012; 0.048). PS from "carbonated soft drinks" in males (OR = 1.001; 95% CI 1.000; 1.002) and "bread and rolls" in females (OR = 1.002; 95% CI 1.000; 1.004) were associated with higher probability of having obesity, while "sweet bakery products" were associated with lower probability of having obesity (OR = 0.996; 95% CI 0.991; 0.999) in females. The present study suggests association between PS of ED foods and obesity in European adolescents. Prospective studies are needed to examine the effect of prolonged exposure to large PS and obesity development.

Food portion sizes, obesity, and related metabolic complications in children and adolescents / Tamaño de las porciones de alimentos, obesidad y complicaciones metabólicas asociadas en niños y adolescentes

The purpose of this narrative review is to provide evidence for the impact of food portion sizes on the development of obesity in children and adolescents. Strategies are needed on portion size estimation and on the relationship of portion size with certain health problems such as obesity, insulin resistance, and emotional eating in all age groups, in order to provide information for parents, teachers, and health professionals aiming to promote healthy eating. A wide range of controlled laboratory studies have found that portion size (PS) had the strongest effect on the amount of food consumed. The effect of PS on total energy intake has been already observed with different types of foods and beverages, especially with energy-dense foods. The influence of large PS was persistent and happened regardless of demographic characteristics such as age, gender, income level, or body mass index. Although a direct causal link between PS and obesity remains controversial, some health and dietetics organizations recommend to moderate PS, especially for energy-dense foods. Research studies in both laboratory and free-living contexts are needed to determine the causal link between increased PS, obesity, and related metabolic complications in children and adolescents

El objetivo de esta revisión narrativa es proporcionar evidencia actual sobre el impacto del tamaño de las porciones de alimentos sobre el desarrollo de la obesidad en niños y adolescentes. Son necesarias estrategias sobre la estimación del tamaño de las porciones y su relación con ciertos problemas de salud como la obesidad, la resistencia a la insulina y la alimentación emocional en todos los grupos de edad, a fin de proporcionar una comunicación efectiva para los padres, los profesores y los profesionales de la salud, teniendo por objetivo promover una alimentación saludable. Varios son los estudios que encontraron asociaciones positivas entre el tamaño de la porción y la cantidad de alimentos consumidos. También se ha observado que el tamaño de la porción influye en la ingesta total de energía, especialmente en el caso de los alimentos de elevada densidad energética, siendo este efecto independiente de las características demográficas, como la edad, el género, el nivel socioeconómico o el índice de masa corporal. La relación causal entre el tamaño de las porciones y la obesidad sigue siendo controvertida; algunas organizaciones de salud y dietética recomiendan moderar los tamaños de las porciones, especialmente tratándose de alimentos de elevada densidad energética. Por ello se necesitan más estudios a corto y largo plazo que puedan determinar la relación causal entre el aumento del tamaño de las porciones, la obesidad y las complicaciones metabólicas asociadas en niños y adolescentes

Free Sugar Consumption and Obesity in European Adolescents: The HELENA Study.

Few studies have evaluated the association between dietary free sugars intake (FSI) and obesity in adolescents. We examined the relation between FSI and their contributors from the main food groups and obesity in European adolescents. We included 843 adolescents (51.6% male) from the cross-sectional HELENA study with two completed 24 h recalls and anthropometric data. Linear mixed models were applied to investigate the relation between FSI and different anthropometric indices. Odds ratios for having a high body mass index (BMI) were also estimated by multilevel ordinal regression. Total FSI was higher in males than females (102.60 g and 87.58 g, respectively, p < 0.001). No effect was observed between free sugar from the main food groups and BMI. Consumers of FSI from "cakes, pies and biscuits" in males (odd ratio (OR) = 0.455; 95% Confidence interval (CI) 0.251, 0.824) and from "breakfast cereals" in females had a lower probability of having obesity (OR = 0.423; 95%CI 0.204, 0.878), whereas females consuming FSI from 'fruit and vegetables juices' had a higher probability of obesity (OR= 2.733; 95% CI 1.286, 5.810). This study provides no evidence that increased FSI is associated with obesity in adolescents. Further studies are needed to assess the longitudinal exposure to FSI and their effect on obesity development.