Portion Sizes of Ultra-Processed Foods in the United States, 2002 to 2021.

Objectives. To assess the US food industry's response to calls from public health authorities to reduce portion sizes by comparing current with past sizes of selected examples of single-serve ultra-processed packaged and fast foods. Methods. We obtained manufacturers' information about current portion sizes and compared it with sizes when first introduced and in 2002. Results. Few companies in our sample reduced portion sizes since 2002; all still sold portions of ultra-processed foods in up to 5-times-larger sizes than when first introduced. Conclusions. Policies and practices focused on reducing portion size could help discourage the consumption of excessive amounts of ultra-processed foods. (Am J Public Health. 2021;111(12):2223-2226. https://doi.org/10.2105/AJPH.2021.306513).

An ethnographic study exploring factors that minimize lunch waste in Tokyo elementary schools.

OBJECTIVE: To explore factors that minimize lunch waste in Tokyo elementary schools and to consider how such factors can be modified and applied in US schools. DESIGN: Focused ethnographic study using interviews, observation, participant observation and document review. Data were analysed using thematic analysis. SETTING: Tokyo, Japan. PARTICIPANTS: Five school dietitians participated in the study. Data collection methods included in-depth interviews, observation of nutrition education lessons, participant observation of school lunchtime and review of relevant school documents (e.g. lunch menus, food waste records). RESULTS: Five themes emerged from the analysis: (i) reinforcement of social norms to eat without waste; (ii) menu planning to increase exposure to unfamiliar and/or disliked foods; (iii) integration of food and nutrition education into the school curriculum; (iv) teacher lunchtime practices related to portion sizes, distributing leftover food and time management; and (v) engagement of students in reducing school lunch waste. Practical and tangible applications to US schools include measuring and reporting lunch waste to influence social norms, teaching students about the importance of reducing food waste, offering flexible school lunch portion sizes and providing students with meaningful opportunities to contribute to solving the problem of school lunch waste. CONCLUSIONS: Japan offers a model for minimizing school lunch waste through a holistic approach that includes factors that operate at and interact across multiple levels of society. Modifying and applying such an approach in US schools is worth considering given the urgent need to address food waste in order to support healthy diets and sustainable food systems.

Understanding price incentives to upsize combination meals at large US fast-food restaurants.

OBJECTIVE: To understand price incentives to upsize combination meals at fast-food restaurants by comparing the calories (i.e. kilocalories; 1 kcal = 4·184 kJ) per dollar of default combination meals (as advertised on the menu) with a higher-calorie version (created using realistic consumer additions and portion-size changes). DESIGN: Combination meals (lunch/dinner: n 258, breakfast: n 68, children's: n 34) and their prices were identified from online menus; corresponding nutrition information for each menu item was obtained from a restaurant nutrition database (MenuStat). Linear models were used to examine the difference in total calories per dollar between default and higher-calorie combination meals, overall and by restaurant. SETTING: Ten large fast-food chain restaurants located in the fifteen most populous US cities in 2017-2018. PARTICIPANTS: None. RESULTS: There were significantly more calories per dollar in higher-calorie v. default combination meals for lunch/dinner (default: 577 kJ (138 kcal)/dollar, higher-calorie: 707 kJ (169 kcal)/dollar, difference: 130 kJ (31 kcal)/dollar, P < 0·001) and breakfast (default: 536 kJ (128 kcal)/dollar, higher-calorie: 607 kJ (145 kcal)/dollar, difference: 71 kJ (17 kcal)/dollar, P = 0·009). Results for children's meals were in the same direction but were not statistically significant (default: 536 kJ (128 kcal)/dollar, higher-calorie: 741 kJ (177 kcal)/dollar, difference: 205 kJ (49 kcal)/dollar, P = 0·053). Across restaurants, the percentage change in calories per dollar for higher-calorie v. default combination meals ranged from 0·1 % (Dunkin' Donuts) to 55·0 % (Subway). CONCLUSIONS: Higher-calorie combination meals in fast-food restaurants offer significantly more calories per dollar compared with default combination meals, suggesting there is a strong financial incentive for consumers to 'upsize' their orders. Future research should test price incentives for lower-calorie options to promote healthier restaurant choices.

Ratios of Food Amounts across Three Portion Size Categories on a Food Frequency Questionnaire in Men and Women.

BACKGROUND: For some quantitative food frequency questionnaire (QFFQ) items, data may be insufficient to set gram weights for multiple portion size (PS) categories. Ratios of food amounts across PS categories may be used to quantify these PS for less frequently consumed food items. OBJECTIVE: To explore the ratios of food amounts reported in 24-hour dietary recalls (24HDRs) by a sample of participants in a cohort study who chose the A (smallest) or C (largest) PS category on the QFFQ, relative to the food amounts for those who chose the B PS category. DESIGN: This study was conducted as a cross-sectional design. PARTICIPANTS/SETTING: Data were from participants (n=2,360) who completed three 24HDRs and the QFFQ in a calibration study of the Multiethnic Cohort Study in 1994-1997. MAIN OUTCOME MEASURES: Median food amounts were calculated from 24HDRs for participants who selected each PS category (A, smallest; B; and C, largest) of items on the QFFQ. A-to-B and C-to-B ratios were computed if reported by five or more people in the 24HDRs: A-to-B ratios for 68 items (men) and 88 items (women); C-to-B ratios for 93 items (men) and 79 items (women). STATISTICAL ANALYSES PERFORMED: The t test was used to compare the mean A-to-B ratios and C-to-B ratios as preset on the QFFQ with those from the 24HDRs and to examine sex differences. Analysis of variance was used to compare the mean ratios among race and ethnicity groups. RESULTS: Mean A-to-B and C-to-B ratios were 0.71±0.15 and 1.45±0.35 in men and 0.71±0.15 and 1.44±0.40 in women based on the 24HDRs. Compared with the original QFFQ PS (A-to-B ratio=0.5±0.07; C-to-B ratio=1.8±0.30), the ratios were closer to 1 both in men and women (P<0.001). There were no significant sex differences or racial or ethnic differences. CONCLUSIONS: These results provide guidance on appropriate ratios to use to set values for small and large PS categories on a QFFQ, particularly for items with insufficient information on usual PS.

Differences in energy and nutritional content of menu items served by popular UK chain restaurants with versus without voluntary menu labelling: A cross-sectional study.

BACKGROUND: Poor diet is a leading driver of obesity and morbidity. One possible contributor is increased consumption of foods from out of home establishments, which tend to be high in energy density and portion size. A number of out of home establishments voluntarily provide consumers with nutritional information through menu labelling. The aim of this study was to determine whether there are differences in the energy and nutritional content of menu items served by popular UK restaurants with versus without voluntary menu labelling. METHODS AND FINDINGS: We identified the 100 most popular UK restaurant chains by sales and searched their websites for energy and nutritional information on items served in March-April 2018. We established whether or not restaurants provided voluntary menu labelling by telephoning head offices, visiting outlets and sourcing up-to-date copies of menus. We used linear regression to compare the energy content of menu items served by restaurants with versus without menu labelling, adjusting for clustering at the restaurant level. Of 100 restaurants, 42 provided some form of energy and nutritional information online. Of these, 13 (31%) voluntarily provided menu labelling. A total of 10,782 menu items were identified, of which total energy and nutritional information was available for 9605 (89%). Items from restaurants with menu labelling had 45% less fat (beta coefficient 0.55; 95% CI 0.32 to 0.96) and 60% less salt (beta coefficient 0.40; 95% CI 0.18 to 0.92). The data were cross-sectional, so the direction of causation could not be determined. CONCLUSION: Menu labelling is associated with serving items with less fat and salt in popular UK chain restaurants. Mandatory menu labelling may encourage reformulation of items served by restaurants. This could lead to public health benefits.

Cambios en la intención de compra de porciones de alimentos al aumentar el presupuesto en un ambiente simulado / Changes in the intention to purchase portions of food when the budget increases in a simulated environment

FUNDAMENTOS: El ingreso económico es un determinante clave en la elección de alimentos. El objetivo fue determinar el cambio en la intención de compra de porciones de alimentos cuando el presupuesto aumenta en un entorno de compra simulado. MÉTODOS: Estudio de intervención no aleatorizado en 70 adultos de 18 a 70 años responsables de las compras en el hogar. Se realizaron 2 compras no consecutivas de alimentos, en un supermercado online. Para cada compra se asignó un monto de dinero, primero de 87.220 CLP (134,2 USD) y segundo de 235.400 CLP (362,2 USD). Los participantes fueron clasificados según años de escolaridad. Los alimentos comprados se transformaron en porciones de consumo. RESULTADOS: La edad promedio fue de 42,1 +/- 13,5 años. Aquellos con ≤12 años de escolaridad aumentan la mediana de consumo de frutas y verduras en 1,7 porciones/día; de alimentos ricos en azúcares (ARA) 2,9 porciones/día y legumbres 2,1 porciones/semana cuando aumenta el presupuesto destinado a la compra, en comparación con los de mayor escolaridad que aumentan a 1,4 porciones / día de frutas y verduras; 2,2 porciones/día de ARA. Los participantes con mayor escolaridad tienen elecciones alimentarias más saludables con el monto 1 en comparación con los de menor escolaridad. CONCLUSIONES: Cuando aumenta el presupuesto para comprar alimentos, las familias tienden a elegir más alimentos saludables, independientemente del nivel educacional

BACKGROUND: The economic income is a key determinant the choice of food. The objective was to determine the change in intention to purchase food portions when the budget increases in a simulated purchase environment. METHODS: A non-randomized intervention study was conducted on 70 adults aged 18-70 years responsible for home purchases. Two non-consecutive purchases of food were made in an online supermarket. For each purchase, an amount of money was allocated, the first of CH $ 87,220 (USD $ 134.2) and the second of CH $ 235,400 (USD $ 362.2). The participants were classified according to years of schooling. The purchased foods were transformed into consumption portions. RESULTS:The mean age was 42.1 +/- 13.5 years. In those ≤12 years of schooling increase the median consumption of fruits and vegetables by 1.7 servings / day; of foods rich in sugars (ARA) 2.9 servings / day and legumes 2.1 servings / week when the budget allocated to the purchase increases, compared to those with higher schooling that increase to 1.4 servings / day of fruits and vegetables; 2.2 servings / day of ARA. Participants with higher education have healthier food choices with the amount 1 compared to those with less education. CONCLUSIONS: Families when they have a higher income tend to choose a greater amount of foods considered healthy, regardless of the educational level

Comparison between serving sizes of cakes and muffins sold in Australian supermarkets and coffee shop chains.

AIM: Cakes and muffins are commonly consumed discretionary foods that have increased significantly in portion size over the past decades. The present study aimed to (i) investigate serving sizes and energy per serving of cakes and muffins sold in supermarkets and coffee chains, (ii) compare to standard discretionary serves and (iii) propose feasible and appropriate serving size recommendations. METHODS: Serving sizes and energy content of cakes and muffins were collected from four major Australian supermarkets (n = 219) and eight coffee chains (n = 248) between March and April 2017 and classified into eight categories and compared using Mann-Whitney tests. Median energy per serving of cakes and muffins from supermarkets and coffee chains were compared to the Australian Dietary Guidelines standard serve of 600 kJ for discretionary food. RESULTS: The median serving size of cakes and muffins from supermarkets, 58 g (interquartile range, IQR: 47-83) and their energy content, 915 kJ (IQR: 745-1243) were significantly smaller compared with coffee chain equivalents, 148 g (IQR: 115-171, P < 0.001) and 1805 kJ (IQR: 1436-2004, P < 0.001), respectively. The majority of cakes and muffins exceeded the Australian Dietary Guidelines standard serve (78% from supermarkets and 99% from coffee chains). CONCLUSIONS: The larger servings of cakes and muffins sold in coffee chains contain nearly double the energy content of smaller servings sold in supermarkets. We recommend reference serving sizes for industry and food retail are set for this category, in combination with consumer education to guide consumers to select appropriate portion sizes.

Avoiding hunger or attaining fullness? Implicit goals of satiety guide portion selection and food intake patterns.

Although implicit theories have been studied in the context of personal traits, there has been limited investigation of their role in physiological domains such as appetite. Subjective feelings and affective states can function as goals and desired end states that individuals regulate their behaviors to attain. Likewise, different conceptualizations people maintain for the subjective experience of satiety (i.e., terminating hunger or attaining fullness) may also predict individual variations in eating behavior. We examined whether portion selection and food intake were guided by such implicit goals pertaining to the nature of satiety. Across 3 studies, we observed that individuals report distinct subjective requirements (degrees of fullness) to attain different states of satiety (stop hunger, feel comfortably full, feel completely full), suggesting that these states reflect independent goals or outcomes. Importantly, personal requirements to feel completely full (compared to stop hunger or feel comfortably full) were observed to be the strongest predictor of portion sizes selected in Study 1 (B = 1.17, p < .001) and Study 2 (B = 4.26, p = .004), and the quantity of energy consumed from a meal in Study 2 (B = 3.07, p = .01). Yet, experimentally activating a situational goal to stop hunger (vs. feel full) produced the selection of smaller portion sizes, F(1, 41) = 5.64, p = .02, and personal requirements to stop hunger to become the dominant predictor of portion selection patterns in Study 3 (B = 0.43, p = .005). These findings reveal that eating behaviors of modern consumers may be guided by a predominant goal to attain the subjective experience of complete fullness, although this implicit goal may be malleable to situational demands.

Food portion size influences accompanying beverage selection in adults.

When trying to reduce food portion size, it is important that meal satisfaction is, as far as possible, preserved. Otherwise, individuals may select accompaniments to the meal (e.g., snacks, beverages) to achieve satisfaction and, in doing so, negate any benefit of the original portion size reduction. This study investigated whether varying portion sizes of food would influence choice of accompanying beverages. That is, when presented with a food portion size that is smaller or larger than their ideal, an individual may compensate by choosing a beverage based on its satiating and/or orosensory properties to balance the expected satiation and satisfaction of a meal. Data from an online interactive study (n = 93) was analysed using multilevel ordinal logistic regression models. Food portion size (100, 300, 500, 700, or 900 kcal) predicted beverage choice (water, low-energy sweetened beverage, high-energy sweetened beverage). For example, the sweetened beverages were more likely to be selected with small food portion sizes (p < .001). Participant ideal food portion size did not interact with this relationship. Participants appear to have recognised that sweetened beverages provide flavour and/or energy, and used them to compensate for a smaller meal. While switching to a low-energy beverage with an increased food portion size is advantageous for energy balance, choosing a high-energy beverage with a decreased food portion size is likely to be detrimental for those attempting to reduce energy intake and body weight.

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

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

(Over)eating out at major UK restaurant chains: observational study of energy content of main meals.

OBJECTIVES: To examine the energy content of main meals served in major UK restaurant chains and compare the energy content of meals in fast food and "full service" restaurant chains. DESIGN: Observational study. SETTING: Menu and nutritional information provided by major UK restaurant chains. MAIN OUTCOME MEASURES: Mean energy content of meals, proportion of meals meeting public health recommendations for energy consumption (≤600 kcal), and proportion of meals with excessive energy content (≥1000 kcal). RESULTS: Main meals from 27 restaurant chains (21 full service; 6 fast food) were sampled. The mean energy content of all eligible restaurant meals (13 396 in total) was 977 (95% confidence interval 973 to 983) kcal. The percentage of all meals that met public health recommendations for energy content was low (9%; n=1226) and smaller than the percentage of meals with an excessive energy content (47%; 6251). Compared with fast food restaurants, full service restaurants offered significantly more excessively calorific main meals, fewer main meals meeting public health recommendations, and on average 268 (103 to 433) kcal more in main meals. CONCLUSIONS: The energy content of a large number of main meals in major UK restaurant chains is excessive, and only a minority meet public health recommendations. Although the poor nutritional quality of fast food meals has been well documented, the energy content of full service restaurant meals in the UK tends to be higher and is a cause for concern. REGISTRATION: Study protocol and analysis strategy pre-registered on Open Science Framework (https://osf.io/w5h8q/).

Portion Sizes from 24-Hour Dietary Recalls Differed by Sex among Those Who Selected the Same Portion Size Category on a Food Frequency Questionnaire.

BACKGROUND: Accounting for sex differences in food portions may improve dietary measurement; however, this factor has not been well examined. OBJECTIVE: The aim of this study was to examine sex differences in reported food portions from 24-hour dietary recalls (24HDRs) among those who selected the same portion size category on a quantitative food frequency questionnaire (QFFQ). DESIGN: This study was conducted with a cross-sectional design. PARTICIPANTS/SETTING: Participants (n=319) were members of the Hawaii-Los Angeles Multiethnic Cohort who completed three 24HDRs and a QFFQ in a calibration study conducted in 2010 and 2011. MAIN OUTCOME MEASURES: Portions of individual foods reported from 24HDRs served as the outcome measures. STATISTICAL ANALYSES PERFORMED: Mean food portions from 24HDRs were compared between men and women who reported the same portion size on the QFFQ, after adjustment for race/ethnicity using a linear regression model. Actual amount and the assigned amount of the selected portion size in the QFFQ were compared using one-sample t test for men and women separately. RESULTS: Of 163 food items with portion size options listed in the QFFQ, 32 were reported in 24HDRs by ≥20 men and ≥20 women who selected the same portion size in the QFFQ. Although they chose the same portion size on the QFFQ, mean intake amounts from 24HDRs were significantly higher for men than for women for "beef/lamb/veal," "white rice," "brown/wild rice," "lettuce/tossed salad," "eggs cooked/raw," "whole wheat/rye bread," "buns/rolls," and "mayonnaise in sandwiches." For men, mean portions of 14 items from the 24HDRs were significantly different from the assigned amounts for QFFQ items (seven higher and seven lower), whereas for women, mean portions of 14 items were significantly lower from the assigned amounts (with five significantly higher). CONCLUSIONS: These sex differences in reported 24HDR food portions-even among participants who selected the same portion size on the QFFQ-suggest that the use of methods that account for differences in the portions consumed by men and women when QFFQs are quantified may provide more accurate absolute dietary intakes.

Reliability and Validity of Digital Imagery Methodology for Measuring Starting Portions and Plate Waste from School Salad Bars.

BACKGROUND: Scientifically sound methods for investigating dietary consumption patterns from self-serve salad bars are needed to inform school policies and programs. OBJECTIVE: To examine the reliability and validity of digital imagery for determining starting portions and plate waste of self-serve salad bar vegetables (which have variable starting portions) compared with manual weights. DESIGN/METHODS: In a laboratory setting, 30 mock salads with 73 vegetables were made, and consumption was simulated. Each component (initial and removed portion) was weighed; photographs of weighed reference portions and pre- and post-consumption mock salads were taken. Seven trained independent raters visually assessed images to estimate starting portions to the nearest » cup and percentage consumed in 20% increments. These values were converted to grams for comparison with weighed values. STATISTICAL ANALYSES: Intraclass correlations between weighed and digital imagery-assessed portions and plate waste were used to assess interrater reliability and validity. Pearson's correlations between weights and digital imagery assessments were also examined. Paired samples t tests were used to evaluate mean differences (in grams) between digital imagery-assessed portions and measured weights. RESULTS: Interrater reliabilities were excellent for starting portions and plate waste with digital imagery. For accuracy, intraclass correlations were moderate, with lower accuracy for determining starting portions of leafy greens compared with other vegetables. However, accuracy of digital imagery-assessed plate waste was excellent. Digital imagery assessments were not significantly different from measured weights for estimating overall vegetable starting portions or waste; however, digital imagery assessments slightly underestimated starting portions (by 3.5 g) and waste (by 2.1 g) of leafy greens. CONCLUSIONS: This investigation provides preliminary support for use of digital imagery in estimating starting portions and plate waste from school salad bars. Results might inform methods used in empirical investigations of dietary intake in schools with self-serve salad bars.

Seeing more and eating less: Effects of portion size granularity on the perception and regulation of food consumption.

Overeating and resulting obesity is a public health concern in the United States, and portion size is a factor that contributes to these problems (Zlatevska, Dubelaar, & Holden, 2014). The present research demonstrates that the granularity of labels used to describe portions also influences food consumption, independent of previously documented portion size effects. Across 6 studies and 7 different food items, we find a robust and reliable effect of portion size granularity labels on consumption intentions and food consumption. Having people think about food using fine-grained labels leads them to decrease their consumption intentions (Study 1, n = 80) and ultimately eat less food (Study 2a, n = 79; Study 2b, n = 79). This process operates by shifting people's perceptions of the size of foods (rather than changing levels of construal) whereby portions described with fine-grained labels (e.g., "15 gummy candies") are perceived to be bigger than portions described with gross-grained labels (e.g., "one serving;" Study 3, n = 200). In addition, granularity facilitates self-regulation of consumption for individuals with a weight-loss goal both when self-regulation is measured (Study 4, n = 160) and when we manipulate that mediator (Study 5, n = 300). Finally, a high-powered registered report replicated effects of granularity on consumption via shifts in perception and intentions with a diverse community sample (Study 6, n = 323). Implications for theory and practice are discussed. (PsycINFO Database Record

Association between excess weight and beverage portion size consumed in Brazil.

OBJECTIVE To describe the beverage portion size consumed and to evaluate their association with excess weight in Brazil. METHODS We used data from the National Dietary Survey, which included individuals with two days of food record aged over 20 years (n = 24,527 individuals). The beverages were categorized into six groups: soft drink, 100% fruit juice, fruit drink, alcoholic beverage, milk, and coffee or tea. We estimated the average portion consumed for each group and we evaluated, using linear regression, the association between portion size per group and the variables of age, sex, income, and nutritional status. We tested the association between portion size and excess weight using Poisson regression, adjusted for age, sex, income, and total energy intake. RESULTS The most frequently consumed beverages in Brazil were coffee and tea, followed by 100% fruit juices, soft drinks, and milk. Alcoholic beverages presented the highest average in the portion size consumed, followed by soft drinks, 100% fruit juice, fruit drink, and milk. Portion size showed positive association with excess weight only in the soft drink (PR = 1.19, 95%CI 1.10-1.27) and alcoholic beverage groups (PR = 1.20, 95%CI, 1.11-1.29), regardless of age, sex, income, and total energy intake. CONCLUSIONS Alcoholic beverages and soft drinks presented the highest averages in portion size and positive association with excess weight. Public health interventions should address the issue of portion sizes offered to consumers by discouraging the consumption of large portions, especially sweetened and low nutritional beverages.

Association between excess weight and beverage portion size consumed in Brazil / Associação entre excesso de peso e tamanho das porções de bebidas consumidas no Brasil

ABSTRACT OBJECTIVE To describe the beverage portion size consumed and to evaluate their association with excess weight in Brazil. METHODS We used data from the National Dietary Survey, which included individuals with two days of food record aged over 20 years (n = 24,527 individuals). The beverages were categorized into six groups: soft drink, 100% fruit juice, fruit drink, alcoholic beverage, milk, and coffee or tea. We estimated the average portion consumed for each group and we evaluated, using linear regression, the association between portion size per group and the variables of age, sex, income, and nutritional status. We tested the association between portion size and excess weight using Poisson regression, adjusted for age, sex, income, and total energy intake. RESULTS The most frequently consumed beverages in Brazil were coffee and tea, followed by 100% fruit juices, soft drinks, and milk. Alcoholic beverages presented the highest average in the portion size consumed, followed by soft drinks, 100% fruit juice, fruit drink, and milk. Portion size showed positive association with excess weight only in the soft drink (PR = 1.19, 95%CI 1.10-1.27) and alcoholic beverage groups (PR = 1.20, 95%CI, 1.11-1.29), regardless of age, sex, income, and total energy intake. CONCLUSIONS Alcoholic beverages and soft drinks presented the highest averages in portion size and positive association with excess weight. Public health interventions should address the issue of portion sizes offered to consumers by discouraging the consumption of large portions, especially sweetened and low nutritional beverages.

RESUMO OBJETIVO Descrever o tamanho das porções de bebidas consumidas e avaliar sua associação com excesso de peso no Brasil. MÉTODOS Utilizou-se dados do Inquérito Nacional de Alimentação, incluindo indivíduos com dois dias de registro alimentar, acima de 20 anos de idade (n = 24.527 indivíduos). As bebidas foram categorizadas em seis grupos: refrigerante; suco; refresco; bebida alcóolica; leite; e café ou chá. Estimou-se a porção média por ocasião de consumo para cada grupo e avaliou-se, por meio de regressão linear, a associação entre tamanho da porção por grupo e as variáveis idade, sexo, renda e estado nutricional. A associação entre tamanho da porção e excesso de peso foi testada por meio de regressão de Poisson, ajustada por idade, sexo, renda e ingestão total de energia. RESULTADOS As bebidas com maior frequência de consumo no Brasil foram café e chá, seguidas dos sucos, refrigerantes e leite. As bebidas alcóolicas apresentaram maior média no tamanho da porção consumida, seguidas dos refrigerantes, sucos, refrescos e leite. O tamanho da porção mostrou associação positiva com excesso de peso somente no grupo dos refrigerantes (RP = 1,19; IC95% 1,10-1,27), e bebidas alcoólicas (RP = 1,20; IC95% 1,11-1,29), independentemente da idade, sexo, renda e ingestão total de energia. CONCLUSÕES Bebidas alcoólicas e refrigerantes apresentaram as maiores médias no tamanho da porção e associação positiva com excesso de peso. Intervenções de saúde pública devem abranger a questão do tamanho das porções oferecidas aos consumidores, desencorajando o consumo de grandes porções, principalmente das bebidas adicionadas de açúcar e de baixo teor nutricional.

El desayuno en Paraguay: a spectos cuantitativos y cualitativos / No disponible

No disponible

Self-reported overeating and attributions for food intake.

OBJECTIVE: We examined whether people's attributions for their eating behaviour differ according to whether they believe they have eaten more, less or about the same as they normally would. DESIGN: Participants were served a small or large portion of pasta for lunch. Afterwards, they were asked to compare how much they ate in the study to how much they normally eat for lunch, resulting in three intake-evaluation categories: 'ate less', 'ate about the same' or 'ate more'. MAIN OUTCOME MEASURES: How much participants ate; the extent to which they attributed their food intake to an internal cue (i.e. hunger) and an external cue (i.e. the amount of food served). RESULTS: Participants served a large portion ate more than those served a small portion, but the magnitude of the portion-size effect did not vary across intake-evaluation categories. Furthermore, although participants in all groups indicated that their hunger influenced how much they ate, only those in the 'ate more' group indicated that the amount of food available influenced how much they ate. CONCLUSION: People appear to be willing to explain their food intake in terms of an external cue only when they believe that they have eaten more than they normally would.

Does the incorporation of portion-control strategies in a behavioral program improve weight loss in a 1-year randomized controlled trial?

BACKGROUND/OBJECTIVES: Controlling food portion sizes can help reduce energy intake, but the effect of different portion-control methods on weight management is not known. In a 1-year randomized trial, we tested whether the efficacy of a behavioral weight-loss program was improved by incorporating either of the two portion-control strategies instead of standard advice about eating less. SUBJECTS/METHODS: The Portion-Control Strategies Trial included 186 women with obesity (81%) or overweight (19%). Participants were randomly assigned to one of three equally intensive behavioral programs, consisting of 19 individual sessions over 12 months. The Standard Advice Group was instructed to eat less food while making healthy choices, the Portion Selection Group was instructed to choose portions based on the energy density using tools such as food scales and the Pre-portioned Foods Group was instructed to structure meals around pre-portioned foods such as single-serving main dishes, for which some vouchers were provided. In an intention-to-treat analysis, a mixed-effects model compared weight loss trajectories across 23 measurements; at month 12, weight was measured for 151 participants (81%). RESULTS: The trajectories showed that the Pre-portioned Foods Group initially lost weight at a greater rate than the other two groups (P=0.021), but subsequently regained weight at a greater rate (P=0.0005). As a result, weight loss did not differ significantly across groups at month 6 (mean±s.e. 5.2±0.4 kg) or month 12 (4.5±0.5 kg). After 1 year, measured weight loss averaged 6% of baseline weight. The frequency of using portion-control strategies initially differed across groups, then declined over time and converged at months 6 and 12. CONCLUSIONS: Incorporating instruction on portion-control strategies within a 1-year behavioral program did not lead to a greater weight loss than standard advice. Using pre-portioned foods enhanced early weight loss, but this was not sustained over time. Long-term maintenance of behavioral strategies to manage portions remains a challenge.