Bad popcorn in big buckets: portion size can influence intake as much as taste

The effect of portion size on food intake is robust to brief education and mindfulness exercises

We examined whether a brief education and a brief mindfulness exercise would reduce the effect of portion size on food intake. Participants were randomly assigned to one of the three information conditions (education, mindfulness, or control) and then received a small or large portion of pasta for lunch. Neither education nor mindfulness was effective in reducing the effect of portion size: Overall, participants served a large portion consumed 34 percent more pasta than did those served a small portion. Participants in the mindfulness condition tended to eat less overall than participants did in the two other conditions, but this trend was not significant.

The neurobiology of food intake in an obesogenic environment

The objective of this non-systematic review of the literature is to highlight some of the neural systems and pathways that are affected by the various intake-promoting aspects of the modern food environment and explore potential modes of interaction between core systems such as hypothalamus and brainstem primarily receptive to internal signals of fuel availability and forebrain areas such as the cortex, amygdala and meso-corticolimbic dopamine system, primarily processing external signals. The modern lifestyle with its drastic changes in the way we eat and move puts pressure on the homoeostatic system responsible for the regulation of body weight, which has led to an increase in overweight and obesity. The power of food cues targeting susceptible emotions and cognitive brain functions, particularly of children and adolescents, is increasingly exploited by modern neuromarketing tools. Increased intake of energy-dense foods high in fat and sugar is not only adding more energy, but may also corrupt neural functions of brain systems involved in nutrient sensing as well as in hedonic, motivational and cognitive processing. It is concluded that only long-term prospective studies in human subjects and animal models with the capacity to demonstrate sustained over-eating and development of obesity are necessary to identify the critical environmental factors as well as the underlying neural systems involved. Insights from these studies and from modern neuromarketing research should be increasingly used to promote consumption of healthy foods.

Does food marketing need to make us fat? A review and solutions

Food marketing is often singled out as the leading cause of the obesity epidemic. The present review examines current food marketing practices to determine how exactly they may be influencing food intake, and how food marketers could meet their business objectives while helping people eat healthier. Particular attention is paid to the insights provided by recently published studies in the areas of marketing and consumer research, and those insights are integrated with findings from studies in nutrition and related disciplines. The review begins with an examination of the multiple ways in which 1) food pricing strategies and 2) marketing communication (including branding and food claims) bias food consumption. It then describes the effects of newer and less conspicuous marketing actions, focusing on 3) packaging (including the effects of package design and package-based claims) and 4) the eating environment (including the availability, salience, and convenience of food). Throughout, this review underscores the promising opportunities that food manufacturers and retailers have to make profitable "win-win" adjustments to help consumers eat better.

Type 2 diabetes in Asians: prevalence, risk factors, and effectiveness of behavioral intervention at individual and population levels

This review summarizes the current data on diabetes risk factors, prevalence, and prevention efforts in Asia and Asian migrant populations. Studies indicate that type 2 diabetes mellitus is a large and growing threat to public health in Asian populations. Furthermore, Asian subgroups (e.g., South Asians/Asian Indians, Chinese) have unique risk factor profiles for developing diabetes, which differ from other populations and between Asian ethnic groups. Lifestyle intervention programs are effective in preventing diabetes in Asians, as with other ethnicities. The strength of these findings is lessened by the lack of systematically collected data using objective measurements. Large epidemiologic studies of diabetes prevalence and risk factor profiles and translational trials identifying sustainable and culturally acceptable lifestyle programs for Asian subgroups are needed.

Serving size guidance for consumers: is it effective?

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

Nutrition standards for away-from-home foods in the USA

Away-from-home foods are regulated with respect to the prevention of food-borne diseases and potential contaminants, but not for their contribution to dietary-related chronic diseases. Away-from-home foods have more calories, salt, sugar and fat, and include fewer fruits and vegetables than recommended by national nutrition guidelines. Thus, frequent consumption of away-from-home foods contributes to obesity, hypertension, diabetes, heart disease, and cancer. In light of this, many localities are already adopting regulations or sponsoring programs to improve the quality of away-from-home foods. We review the rationale for developing nutritional performance standards for away-from-home foods in light of limited human capacity to regulate intake or physiologically compensate for a poor diet. We offer a set of model performance standards to be considered as a new area of environmental regulation. Models for voluntary implementation of consumer standards exist in the environmental domain and may be useful templates for implementation. Implementing such standards, whether voluntarily or via regulations, will require addressing a number of practical and ideological challenges. Politically, regulatory standards contradict the belief that adults should be able to navigate dietary risks in away-from-home settings unaided.

"Split them!" smaller item sizes of cookies lead to a decrease in energy intake in children

OBJECTIVE

Examine the influence of altering the size of snack food (ie, small vs large cookies) on short-term energy intake.

METHODS

First- and sixth-graders (n = 77) participated in a between-subjects experimental design. All participants were offered the same gram weight of cookies during an afternoon tea at their school. For half of the participants, food was cut in 2 to make the small item size. Food intake (number of cookies, gram weight, and energy intake) was examined using ANOVA.

RESULTS

Decreasing the item size of food led to a decrease of 25% in gram weight intake, corresponding to 68 kcal. Appetitive ratings and subject and food characteristics had no moderating effect.

CONCLUSIONS AND IMPLICATIONS

Reducing the item size of food could prove a useful dietary prevention strategy based on decreased consumption, aimed at countering obesity-promoting eating behaviors favored by the easy availability of large food portions.

Feed-forward mechanisms: addiction-like behavioral and molecular adaptations in overeating

Food reward, not hunger, is the main driving force behind eating in the modern obesogenic environment. Palatable foods, generally calorie-dense and rich in sugar/fat, are thus readily overconsumed despite the resulting health consequences. Important advances have been made to explain mechanisms underlying excessive consumption as an immediate response to presentation of rewarding tastants. However, our understanding of long-term neural adaptations to food reward that oftentimes persist during even a prolonged absence of palatable food and contribute to the reinstatement of compulsive overeating of high-fat high-sugar diets, is much more limited. Here we discuss the evidence from animal and human studies for neural and molecular adaptations in both homeostatic and non-homeostatic appetite regulation that may underlie the formation of a "feed-forward" system, sensitive to palatable food and propelling the individual from a basic preference for palatable diets to food craving and compulsive, addiction-like eating behavior.

Implementing Heart Healthy Dietary Guidelines

Over recent decades, abundant scientific evidence has led to authoritative dietary guidelines and recommendations for heart healthy eating and lifestyle behaviors. But most children and adults do not regularly achieve these goals. Consequently, our focus must now be on helping individual patients and our communities implement these guidelines in everyday life. This article reviews current evidence for insights and practical techniques that can help individuals move from ideal goals to real practice of heart healthy nutrition and lifestyle behaviors.

Container size influences snack food intake independently of portion size

While larger containers have been found to increase food intake, it is unclear whether this effect is driven by container size, portion size, or their combination, as these variables are usually confounded. The study was advertised as examining the effects of snack food consumption on information processing and participants were served M&M's for free consumption in individual cubicles while watching a TV show. Participants were served (1) a medium portion of M&M's in a small (n=30) or (2) in a large container (n=29), or (3) a large portion in a large container (n=29). The larger container increased intake by 129% (199 kcal) despite holding portion size constant, while controlling for different confounding variables. This research suggests that larger containers stimulate food intake over and above their impact on portion size.

Features of automaticity in eating behavior

OBJECTIVE

Some authors (e.g. Cohen & Farley, 2008) have argued that control of eating behavior is difficult because this behavior could be an automatic one. Our objective was to test this claim in an experimental design.

METHOD

Automaticity can be diagnosed by looking for the presence of its features in performance or processes. We designed an experiment to test the features of uncontrollability and unconsciousness.

RESULTS

Results showed that individuals' success in controlling their behavior does not depend on their goal or the instruction received (uncontrollability), although individuals believe their goals justify their behavior (unconsciousness). High scores on cognitive restraint were predictive for the success in control of eating behavior.

CONCLUSION

Eating has features of automatic behavior, thus can be diagnosed as such. Our results bear important implications for the research and practice concerning eating behavior, especially obesity.

Seeking better health care outcomes: the ethics of using the "nudge"

Policymakers, employers, insurance companies, researchers, and health care providers have developed an increasing interest in using principles from behavioral economics and psychology to persuade people to change their health-related behaviors, lifestyles, and habits. In this article, we examine how principles from behavioral economics and psychology are being used to nudge people (the public, patients, or health care providers) toward particular decisions or behaviors related to health or health care, and we identify the ethically relevant dimensions that should be considered for the utilization of each principle.

Food plating preferences of children: the importance of presentation on desire for diversity

AIM

Given the importance of food presentation and childhood nutrition, we aimed to test the degree to which adults and children might demonstrate different preferences for various ways in which food can be presented on plates.

METHODS

Twenty-three pre-teen children and 46 adults were individually presented full-size photos of 48 different combinations of food on plates. The photos varied according to seven dimensions (e.g. number of items, placement of entrée and organization of the food).

RESULTS

Contrary to the default assumption that parents and children share preferences for the ways in which food is presented on plates, we find that children have notably different preferences than adults. Most remarkably, we show that children tended to prefer seven different items and six different colours on their ideal plates, while adults tended to prefer three different colours and three different items.

CONCLUSION

The assumption that children prefer food presentations that match adult preferences appears to be unjustified. Future research and interventions that are designed to improve childhood nutrition should test for the impact of diverse presentations on actual food consumption among a variety of populations across institutional settings.

Successful development of satiety enhancing food products: towards a multidisciplinary agenda of research challenges

In the context of increasing prevalence of overweight and obesity in societies worldwide, enhancing the satiating capacity of foods may help people control their energy intake and weight. This requires an integrated approach between various food-related disciplines. By structuring this approach around the new product development process, this paper aims to present the contours of such an integrative approach by going through the current state of the art around satiety enhancing foods. It portrays actual food choice as the end result of a complex interaction between internal satiety signals, other food benefits, and environmental cues. Three interrelated routes to satiating enhancement are to change the food composition to develop stronger physiological satiation and satiety signals, anticipate and build on smart external stimuli at the moment of purchase and consumption, and improve palatability and acceptance of satiety enhanced foods. Key research challenges in achieving these routes in the field of nutrition, food technology, consumer, marketing, and communication are outlined.

Functional food and satiety. Impact of a satiating context effect on appetite control of non-obese men

The aim of this study was to verify if the addition of satiating nutrients and a satiating context effect could influence appetite sensations, spontaneous energy intake and food appreciation under conditions of standardized energy density of a meal. Eighteen non-obese men were submitted to a control, a satiating, and a context effect condition composed of a standardized breakfast and an ad libitum test lunch (macaroni entrée plus chocolate cake). The satiating macaroni contained more proteins, unsaturated fats, fibres and calcium than the control macaroni despite similar energy density, appearance and palatability. In the context effect condition, participants believed they were eating "a highly satiating macaroni", but were served the control macaroni. Appreciation of the macaronis, quantities of macaroni and cake consumed and 4-h satiating potential were measured for each condition. Quantities of macaroni and dessert consumed did not differ between conditions. Satiating potential was greater for the context effect meal compared to the control and/or the satiating meals up to 4h after its consumption. The context effect macaroni obtained higher appreciation rates than the control and the satiating macaronis. The context effect may positively influence the appreciation toward a meal and contribute to increase its satiety potential for many hours.

Increased portion sizes from energy-dense foods affect total energy intake at eating occasions in US children and adolescents: patterns and trends by age group and sociodemographic characteristics, 1977-2006

BACKGROUND

Larger portion sizes of foods and beverages could affect overall energy intake at meals and promote overeating.

OBJECTIVE

We investigated trends in portion sizes of energy-dense foods and energy intakes at eating occasions in US children and adolescents.

DESIGN

Four US nationally representative surveys from 1977 to 2006 were analyzed (n = 31,337). We measured trends in portion sizes (kcal, g, and mL) of selected foods [sugar-sweetened beverages (SSBs), salty snacks, desserts, French fries, burgers, pizzas, and Mexican fast foods] and energy intake (kcal) at eating occasions during which selected foods were consumed. Trends were reported by age group (2-6-, 7-12-, and 13-18-y-olds), sex, and socioeconomic status.

RESULTS

In 2003-2006, the selected foods accounted for 38% of daily energy intake in 13-18-y-olds, 35% of the daily energy intake in 7-12-y-olds, and 28% of the daily energy intake in 2-6-y-olds. In all age groups, larger portion sizes of pizza coincided with higher energy intakes at eating occasions during which pizzas were consumed. In 7-12- and 13-18-y-olds, higher energy intakes at meals coincided with larger portion sizes of SSBs, French fries, or salty snacks. In all age groups, nonsignificant larger portions of Mexican fast foods were related to higher energy intakes at meals. Adolescent boys consumed larger portion sizes of the selected foods and had higher energy intakes at meals for all periods than did girls (P < 0.01). The percentage of kilocalories from pizza within a meal increased more sharply in non-Hispanic African Americans, in Hispanics, and in the group with a low household education than in the other groups.

CONCLUSIONS

Adolescents are more susceptible to increased portion sizing than are younger children. The group of non-Hispanic African Americans and Hispanics and individuals with a lower education represents key concerns for public health policies.

Emerald dragon bites vs veggie beans: Fun food names increase children's consumption of novel healthy foods

Caregivers often struggle with food neophobia on the part of young children. This study examined whether labeling novel healthy foods with fun names would increase children's willingness to try those foods and encourage them to eat more of those foods in a child care setting. Thirty-nine toddler and preschool age children (mean age = 3.9 years) were served each of three foods twice, once labeled with a fun name and once with a healthy name. Percentage of the food consumed by each child was recorded. Overall, children ate a greater percentage of the target foods when they were labeled with fun names. Also, a larger percentage of the children tasted the foods when they were labeled with fun names. This simple strategy could be effective for increasing consumption of healthy foods among young children.

The Pull of the Past

To identify the factors that disrupt and maintain habit performance, two field experiments tested the conditions under which people eat out of habit, leading them to resist motivational influences. Habitual popcorn eaters at a cinema were minimally influenced by their hunger or how much they liked the food, and they ate equal amounts of stale and fresh popcorn. Yet, mechanisms of automaticity influenced habit performance: Participants ate out of habit, regardless of freshness, only when currently in the context associated with past performance (i.e., a cinema; Study 1) and only when eating in a way that allowed them to automatically execute the response cued by that context (i.e., eating with their dominant hand; Study 2). Across all conditions, participants with weaker cinema-popcorn-eating habits ate because of motivations such as liking for the popcorn. The findings reveal how habits resist conflicting motives and provide insight into promising mechanisms of habit change.

How much should I eat? Situational norms affect young women's food intake during meal time

Portion size and the intake of others have been found to influence people's food intake. No study, however, has tested the potential influences of both types of situational norms on intake during the same eating occasion. We experimentally tested the effects of manipulating portion size and the intake of others on young women's meal intake during a 20 min eating opportunity. An experimental design with a three (confederate's intake: small, standard, large) by two (portion size: small, standard) between-participants design was used. A total of eighty-five young women participated. Portion size and the confederate's intake both influenced young women's intake. Participants consumed more when offered a larger portion than when offered a smaller portion, and they also ate more when their eating companion ate more. The present results indicate that the effects of portion size and the intake of others were independent but additive. Thus, both types of situational norms might independently guide an individual's intake during a single eating occasion.

Food reward, hyperphagia, and obesity

Given the unabated obesity problem, there is increasing appreciation of expressions like "my eyes are bigger than my stomach," and recent studies in rodents and humans suggest that dysregulated brain reward pathways may be contributing not only to drug addiction but also to increased intake of palatable foods and ultimately obesity. After describing recent progress in revealing the neural pathways and mechanisms underlying food reward and the attribution of incentive salience by internal state signals, we analyze the potentially circular relationship between palatable food intake, hyperphagia, and obesity. Are there preexisting individual differences in reward functions at an early age, and could they be responsible for development of obesity later in life? Does repeated exposure to palatable foods set off a cascade of sensitization as in drug and alcohol addiction? Are reward functions altered by secondary effects of the obese state, such as increased signaling through inflammatory, oxidative, and mitochondrial stress pathways? Answering these questions will significantly impact prevention and treatment of obesity and its ensuing comorbidities as well as eating disorders and drug and alcohol addiction.

Serving large portions of vegetable soup at the start of a meal affected children's energy and vegetable intake

This study tested whether varying the portion of low-energy-dense vegetable soup served at the start of a meal affects meal energy and vegetable intakes in children. Subjects were 3- to 5-year-olds (31 boys and 41 girls) in daycare facilities. Using a crossover design, children were served lunch once a week for four weeks. On three occasions, different portions of tomato soup (150, 225, and 300 g) were served at the start of the meal, and on one occasion no soup was served. Children had 10 min to consume the soup before being served the main course. All foods were consumed ad libitum. The primary outcomes were soup intake as well as energy and vegetable intake at the main course. A mixed linear model tested the effect of soup portion size on intake. Serving any portion of soup reduced entrée energy intake compared with serving no soup, but total meal energy intake was only reduced when 150 g of soup was served. Increasing the portion size increased soup and vegetable intake. Serving low-energy-dense, vegetable soup as a first course is an effective strategy to reduce children's intake of a more energy-dense main entrée and increase vegetable consumption at the meal.

The 100-calorie semi-solution: sub-packaging most reduces intake among the heaviest

This study addresses two questions about sub-packaging: (i) Do 100-calorie packages reduce the calorie intake of overweight individuals differently than normal-weight individuals? (ii) Do they enable individuals to accurately track intake? Thirty-seven undergraduates were randomly given either four 100-calorie packages of crackers or one 400-calorie package of crackers to eat while watching television. The average participant ate 25.2% (75.1 calories) less when given four 100-calorie packages of crackers than when given one 400-calorie package (P = 0.006). In addition, much of this influence was driven by overweight participants whose intake decreased by 54.1%. However, all of the participants underestimated their consumption by 60% or more, indicating that sub-packaging does not appear to increase one's accuracy in estimating how much is consumed. Smaller sized sub-packaging most greatly benefits those who are overweight, yet it does so without making people more aware of how much they have eaten.

Estimated portion sizes of snacks and beverages differ from reference amounts and are affected by appetite status in non-obese men

Objective

To explore the extent to which appetite status influences portion size estimation in men under laboratory conditions and to quantify how much participants’ portion estimates differed from the recommended portion sizes defined by authoritative bodies (i.e. government and health professionals’ reference amounts).

Design

Repeated, randomized cross-over trial with each participant attending the laboratory on four separate occasions. At each session, participants rated the number of portions of eight foods and beverages displayed in front of them. Participants rated portions twice after consuming breakfast (full conditions) and twice after an overnight fast (hungry conditions). Portion estimates were compared with reference amounts from the British and American Dietetic Associations, from the UK Food Standards Agency and from the US Food and Drug Administration.

Setting

Food skills laboratory, University of Chester, UK.

Subjects

Twenty-seven non-obese men (mean age 24·9 (sd 6·5) years).

Results

Portion size estimates for all items were significantly smaller under hungry than under full conditions (P < 0·01). Relative to reference instruments, estimates were significantly smaller for all foods except banana, irrespective of appetite status (P < 0·001).

Conclusions

In this data set, appetite status altered the perception of food amounts. There were large discrepancies between participants’ perception of a portion and recommendations from health professionals and government standards. Nutritional educational strategies should take into account the role of hunger along with a person's familiarity with existing portion size systems when advising on portion sizes.

Spatial Metaphor and Real Estate

Metaphors are used to help people understand abstract concepts in terms of perceptual experiences (e.g., “feeling high” or “feeling down”). A consequence of this strategy is that metaphor can bias perception and decision making. For example, consistent with metaphors for affect and spatial perception (up = good, down = bad), people more readily identify positive things when high in location. North and south are abstract concepts, which are also tied by metaphor to spatial perception (north = up, south = down). Based on this, the authors hypothesized that, by virtue of a shared mapping with up and down, north and south may have affective associations (north = good, south = bad) that bias decisions related to housing in terms of location preference and expectations of where others live. The authors found convergent support for this hypothesis across four studies using correlational (Studies 1 and 2) and experimental (Studies 3 and 4) data.

Reducing portion size reduces food intake and plate waste

As portion size (PS) increases, so does food intake. The effect of decreasing PS on food intake in a nonlaboratory setting is unknown. This 5-week study sought to determine whether decreasing PS resulted in decreased intake of the same food, and if so, at what point further PS reductions might lack benefit. It also assessed effects of PS reduction on food production and waste in a university all-you-can-eat dining facility (DF). Subjects were primarily freshmen who regularly ate lunch at the DF, and self-selected French fries (FF) presented in individual paper bags, portioned originally at 88 g, and decreased approximately 15 g/week for 3 weeks. Diners were covertly observed choosing one or more bags. Total FF production and plate waste (PW) were determined daily. Decreasing PS resulted in significant decreases in consumption per diner (P < 0.05) and PW (P < 0.05), and nonsignificant decreases in total FF consumption and production. PS was positively correlated with consumption per diner (r = 0.897, P = 0.001) and PW (r = 0.852, P = 0.001), but inversely correlated with number of diners choosing >or=2 bags (r = -0.809, P = 0.003). Total FF production was positively correlated with PW (r = 0.728, P = 0.011). This study shows that reducing PS of a particular item in an all-you-can-eat environment results in reduced intake of that food for most individuals, and that reducing PS reduces PW and food production.

Infant temperament and eating style predict change in standardized weight status and obesity risk at 6 years of age

OBJECTIVE

Little research has addressed the relationships among infant temperament, eating styles and obesity risk. To address this gap, we tested whether infant temperament and eating patterns at the age of 1 year are associated with a greater increase in standardized weight status, and greater obesity risk at 6 years of age.

DESIGN

A secondary, prospective analysis of the Colorado Adoption Study was conducted. The main predictor variables were infant temperament (that is, emotionality, activity, attention span-persistence, reaction to food and soothability) and eating domains (that is, reactivity to food, predictable appetite and distractability at mealtime) at the age of 1 year, along with the body mass index (BMI) of biological mothers. The outcome measures were child weight and height (length) assessed at ages 1 through 6 years, from which weight-for-length and BMI were computed along with the standardized indexes (z-scores) and percentiles. Overweight/obesity status was computed at each year as well.

PARTICIPANTS

A primarily White sample of 262 boys and 225 girls, assessed at ages 1 through 6 years, along with their mothers.

RESULTS

Among boys, greater attention span-persistence was associated with reduced standardized weight status gain (β=-0.15, P<0.05) and reduced obesity risk (odds ratio (OR)=0.46, P=0.06). Among girls, greater soothability and negative reaction to food were associated with greater standardized weight status gain (β=0.19, P<0.01; and β=0.16, P<0.05, respectively) and increased obesity risk (OR=3.72, P=0.03; and OR=2.81, P=0.08, respectively). Biological mothers' obesity status predicted obesity risk in boys (OR=3.07, P=0.01) and girls (OR=5.94, P=0.03).

CONCLUSIONS

Male infants with less attention span, and female infants with greater soothability or a more negative food reaction, showed greater increases in standardized weight and were more likely to be overweight/obese at the age of 6 years. The role of infant temperament in pediatric obesity onset warrants greater research.

Cash and in-kind transfers in poor rural communities in Mexico increase household fruit, vegetable, and micronutrient consumption but also lead to excess energy consumption

Conditional transfer programs are increasingly popular, but the impact on household nutrient consumption has not been studied. We evaluated the impact of the Programa de Apoyo Alimentario (PAL), a cash and in-kind transfer program, on the energy and nutrient consumption of poor rural households in Mexico. The program has been shown to reduce poverty. Beneficiary households received either a food basket (including micronutrient-fortified milk) or cash. A random sample of 206 rural communities in Southern Mexico was randomly assigned to 1 of 4 groups: a monthly food basket with or without health and nutrition education, a cash transfer with a cost to the government equivalent to the food basket (14 USD/mo) with education, or control. The impact after 14 mo of exposure was estimated in a panel of 5823 households using a double difference regression model with household fixed effects. PAL was associated with increases (P < 0.01) in the consumption of total energy (5-9%), energy from fruits and vegetables (24-28%), and energy from animal source foods (24-39%). It also affected iron, zinc, and vitamin A and C consumption (P < 0.05). The consumption of energy and all nutrients was greater in the food basket group (P < 0.05). Cash and in-kind transfers in populations that are not energy-deficient should be carefully redesigned to ensure that pulling poor families out of poverty leads to improved micronutrient intake but not to increased energy consumption.

Effects of doubling the portion size of fruit and vegetable side dishes on children's intake at a meal

Increasing the portion size of energy-dense entrées has been shown to increase children's energy intake during a meal. It remains to be investigated whether serving larger portions to children can be used to promote intake of more healthful foods, such as fruits and vegetables (F&V). The aim of the present study was to examine the effects of increasing the portion size of F&V side dishes on children's intake. Forty-three children (22 boys, 21 girls), aged 5-6 years, were served dinner once a week for 2 weeks. Each dinner consisted of pasta with tomato sauce, three F&V side dishes (broccoli, carrots, and applesauce), and milk. The portion size of the F&V was doubled between experimental conditions whereas the size of the pasta remained constant. Doubling the portion size of the side dishes resulted in a 43% increase in children's intake of the fruit side dish (P = 0.001), but did not affect children's intake of the two vegetable side dishes (P > 0.60). Further, when the portion size of F&V side dishes was doubled, children ate significantly less of the pasta (P = 0.04). The difference in meal energy intake between portion size conditions (19.5 +/- 16.3 kcal) was not significant (P = 0.24). Although more studies are needed to understand whether increases in portion size can influence vegetable intake, children did eat more in response to a large quantity of a preferred low energy-dense fruit side dish at meals. Thus variations in portion size can be used strategically to help children achieve the recommended intake of fruits.

Small, medium, large or supersize: trends in food portion sizes in The Netherlands

OBJECTIVE

Larger food portion sizes lead to increased energy intake levels and might contribute to the current obesity epidemic. Only a very limited number of studies are available on the actual development of food portion sizes during past decades. The present study aims to reveal trends in portion sizes of some high-energy-dense food products during recent decades in The Netherlands.

DESIGN

The data were collected from manufacturers and from information found in professional journals, marketing and advertising materials, and on manufacturers' websites.

RESULTS

A number of trends in food portion sizes were observed. Larger sizes have been added to the portion size portfolio. The portion sizes of a number of products have also increased since their introduction, although this did not apply to all the products included. Finally, multi-packs have been introduced and the number of products within a multi-pack has also increased.

CONCLUSIONS

A trend towards larger portion sizes was observed, which is relevant to the public health debate regarding the prevention of overweight and obesity. It is recommended that developments in food portion sizes continue to be monitored over the coming years, and the effects of the newly introduced portion sizes on food intake be studied.

Analgesia accompanying food consumption requires ingestion of hedonic foods

Animals eat rather than react to moderate pain. Here, we examined the behavioral, hedonic, and neural requirements for ingestion analgesia in ad libitum fed rats. Noxious heat-evoked withdrawals were similarly suppressed during self-initiated chocolate eating and ingestion of intraorally infused water, sucrose, or saccharin, demonstrating that ingestion analgesia does not require feeding motivation, self-initiated food procurement, sucrose, or calories. Rather, food hedonics is important because neither salt ingestion nor quinine rejection elicited analgesia. During quinine-induced nausea and lipopolysaccharide (LPS)-induced illness, conditions when chocolate eating was presumably less pleasurable, analgesia accompanying chocolate consumption was attenuated, yet analgesia during water ingestion was preserved in LPS-injected rats who showed enhanced palatability for water within this context. The dependence of ingestion analgesia on the positive hedonics of an ingestate was confirmed in rats with a conditioned taste aversion to sucrose: after paired exposure to sucrose and LPS, rats no longer showed analgesia during sucrose ingestion but continued to show analgesia during chocolate consumption. Eating pauses tended to occur less often and for shorter durations in the presence of ingestion analgesia than in its absence. Therefore, we propose that ingestion analgesia functions to defend eating from ending. Muscimol inactivation of the medullary raphe magnus blocked the analgesia normally observed during water ingestion, showing the involvement of brainstem endogenous pain inhibitory mechanisms in ingestion analgesia. Brainstem-mediated defense of the consumption of palatable foods may explain, at least in part, why overeating tasty foods is so irresistible even in the face of opposing cognitive and motivational forces.

Obesity: can behavioral economics help?

BACKGROUND

Consumers regularly and predictably behave in ways that contradict standard assumptions of economic analysis such that they make decisions that prevent them from reaching rationally intended goals. These contradictions play a significant role with respect to consumers' food decisions and the effect these decisions have on their health.

DISCUSSION

Food decisions that are rationally derived include those that trade short-term gains of sensory pleasure (hedonic) for longer term gains of health and wellness (utilitarian). However, extra-rational food decisions are much more common. They can occur because of the contexts in which they are made--such as being distracted or pressed for time. In these contexts, heuristics (or rules of thumb) are used. Because food decisions are made with little cognitive involvement, food policies designed to appeal to highly cognitive thought (e.g., fat taxes, detailed information labels) are likely to have little impact. Furthermore, food marketing environments influence not only what foods consumers buy but also how much. As a general principle, when individuals do not behave in their own interest, markets will feed perverse and sub-optimal behaviors.

CONCLUSION

Given the limited ability of individuals to retain and use accurate health information coupled with varying levels of self control, profit motivations of marketers can become predatory--though not necessarily malicious. Alternative policy options that do not restrict choice are outlined, which enable consumers to make better decisions. These options allow for profit motivations of marketers to align with the long-term well being of the consumer.

Portion size: review and framework for interventions

The prevalence of overweight and obesity has increased. A strong environmental factor contributing to the obesity epidemic is food portion size. This review of studies into the effects of portion size on energy intake shows that increased food portion sizes lead to increased energy intake levels. Important mechanisms explaining why larger portions are attractive and lead to higher intake levels are value for money and portion distortion. This review also shows that few intervention studies aiming to reverse the negative influence of portion size have been conducted thus far, and the ones that have been conducted show mixed effects. More intervention studies targeted at portion size are urgently needed. Opportunities for further interventions are identified and a framework for portion size interventions is proposed. Opportunities for intervention include those targeted at the individual as well as those targeted at the physical, economic, political and socio-cultural environment.

Increased portion size leads to a sustained increase in energy intake over 4 d in normal-weight and overweight men and women

Large food portions may be facilitating excess energy intake (EI) and adiposity among adults. The present study aimed to assess the extent to which EI and amounts of foods consumed are influenced by the availability of different-sized food portions. A randomised within-subject cross-over, fully residential design was used, where forty-three (twenty-one men and twenty-two women) normal-weight and overweight adults were randomly allocated to two separate 4 d periods where they were presented with either 'standard' or 'large' food portions of the same foods and beverages. The main outcome measures were the amount of food (g) and EI (MJ) consumed throughout each study period. Mean EI over 4 d was significantly higher on the large portion condition compared with the standard condition in the total group (59.1 (sd 6.6) v. 52.2 (sd 14.3) MJ; P = 0.020); men and women increased their EI by 17 % (10 (sd 6.5) MJ; P < 0.001) and 10 % (4 (sd 6.5) MJ; P = 0.005) respectively when served the large food portions relative to the standard food portions. The increased intakes were sustained over the 4 d in the large portion condition with little evidence of down-regulation of EI and food intake being made by subjects. Increased food portion size resulted in significant and sustained increases in EI in men and women over 4 d under fully residential conditions. The availability and consumption of larger portions of food may be a significant factor contributing to excess EI and adiposity.

Children's sensitivity to external food cues: how distance to serving bowl influences children's consumption

Overweight is increasing in children, leading to negative health consequences. Children also lack appropriate levels of important vitamins and nutrients in their diets. Environmental cues, such as food proximity, have been shown to influence consumption rates in adults. The present study has tested whether proximity to either a nutrient-dense or caloric-dense food would influence children's snack consumption in a day care setting. Children (N = 46, age range 3.4-11) consumed more of both nutrient- and energy-dense foods when they are sitting closer to the food than if they are sitting farther away from the food, above and beyond the effects of age. The data indicate that it may be possible to increase the consumption of nutrient-dense foods or decrease the consumption of energy-dense foods, respectively, by modifying the proximity of such foods within a child's environment.

Mindless Eating and Healthy Heuristics for the Irrational

Food choice decisions are not the same as intake volume decisions. The former determine what we eat (soup or salad); the latter determine how much we eat (half of the bowl or all of it). Large amounts of money, time, and intelligence have been invested in understanding the physiological mechanisms that influence food choice (James O. Hill, forthcoming). Much less has been invested in understanding how and why our environment influences food consumption volume. Yet environmental factors (such as package size, plate shape, lighting, variety, or the presence of others) affect our food consumption volume far more than we realize (Wansink 2006). Whereas people can acknowledge that environmental factors influence others, they wrongly believe they are unaffected. Perhaps they are influenced at a basic level of which they are not aware. A better understanding of these drivers of consumption volume will have immediate implications for research, policy, and personal interventions. There are three objectives of this paper: (1) explain why environmental factors may unknowingly influence food consumption; (2) identify resulting myths that may lead to is specified models or misguided policy recommendations; and (3) offer clear direction for future research, policy, and personal dietary efforts.

Associations between the portion sizes of food groups consumed and measures of adiposity in the British National Diet and Nutrition Survey

The objective of the present study was to examine the associations between the portion sizes of food groups consumed with measures of adiposity using data from the National Diet and Nutrition Survey of British adults. Seven-day weighed dietary records, physical activity diaries and anthropometric measurements were used. Foods eaten were assigned to thirty different food groups and analyses were undertaken separately for men and women. The median daily portion size of each food group consumed was calculated. The potential mis-reporting [corrected] of dietary energy intake (EI) was identified using the following equation: EI--estimated energy requirements/EER [corrected] x 100 = percentage of under-reporting (UR) of energy needs. Multinomial logistic regression (adjusted for age, social class, physical activity level and UR) was used to determine the portion sizes of food groups most strongly associated with obesity status. Few positive associations between the portion sizes of food groups consumed and obesity status were found. However, UR was prevalent, with a median UR of predicted energy needs of 34 and 33 % in men and women, respectively. After the adjustment was made for UR, more associations between the food groups and obesity status became apparent in both sexes. The present study suggests that the true effect of increased portion size of foods on obesity status may be masked by high levels of UR. Alternatively, these data may indicate that an increased risk of obesity is not associated with specific foods/food groups but rather with an overall increase in the range of foods and food groups being consumed.

Body mass index is increasing faster among taller persons

BACKGROUND

During the past 40 y, there has been a trend toward more eating away from home, increased food availability, the opportunity to order extra-large portion sizes, and general weight gain.

OBJECTIVE

Because shorter people need fewer calories than taller people to maintain their weight, our goal was to determine whether the body mass index (BMI)-height relation has changed over time.

DESIGN

Data are from 3581 nonpregnant women and 3091 men examined in the 1959-1962 National Health Examination Survey and 4651 nonpregnant women and 4691 men examined in the 2001-2004 National Health and Nutrition Examination Survey. We tested whether the relation between BMI and height has changed for men and women, after adjustment for other demographic changes.

RESULTS

In the past, on average, shorter American men and women had significantly higher BMIs than taller people. However, taller people have been increasing their BMI during the past 40 y at a faster rate than shorter people.

CONCLUSIONS

This study documents that the obesity epidemic has changed the height-BMI relation. The data cannot identify causal pathways, and there are numerous explanations. A plausible hypothesis is that changes in the food environment may have eliminated constraints on weight gain for taller people that existed in a more calorie-constrained environment.

State of the Art Reviews: Relationship Between Diet/ Physical Activity and Health

Obesity and 4 of the leading causes of death—heart disease, cancer, stroke, and type 2 diabetes mellitus—are related to lifestyle. The combination of a healthy weight, prudent diet, and daily physical activity clearly plays a role in primary, secondary, and tertiary prevention of these and other chronic diseases. Because nearly 65% of the adult population is overweight or obese, weight loss and maintenance are central to this review article. Improved lipid profiles, blood pressure, insulin sensitivity, and euglycemia are associated with weight loss or a normal body weight; thus, maintaining a healthy weight is a universal recommendation for health. The methods for improving lifestyle described in the section on obesity include assessing nutritional status and stages of change of the client, setting realistic goals, eating a diet high in fruits and vegetables with low-fat sources of dairy and protein, and achieving appropriate physical activity levels. The importance of physicians discussing weight with clients and vice versa is stressed. The common features of lifestyle-related diseases make them amenable to similar lifestyle interventions.

Flavor–nutrient learning independent of flavor–taste learning with college students

Flavor preference learning is mediated by associations with other liked tastes (flavor-taste learning) or calories (flavor-nutrient learning). The present study asked whether flavor-nutrient learning could be exhibited independent of flavor-taste learning in humans (as has been shown in animals). Subjects were 24 undergraduates with a mean age of 19 years. Half the subjects received the bitter-tasting cream cheese crackers with high fat cream cheese, half with low fat cream cheeses. Half the cream cheeses were flavored orange, half banana in each group. Results showed that subjects who had high fat flavored cream cheese rated the flavor more pleasant in plain crackers than subjects who had the flavor in low fat cream cheese (flavor-nutrient learning), although all cream cheese crackers were bitter tasting in training (flavor-taste learning).