Gender, Age, Hunger, and Body Mass Index as Factors Influencing Portion Size Estimation and Ideal Portion Sizes

The interplay between body mass index, motivation for food consumption, and noncommunicable diseases in the European population: A cross-sectional study

INTRODUCTION

Consuming unhealthy foods in emotional states can increase body mass index (BMI), contribute to becoming overweight, and lead to the development of chronic diseases. This study aims to investigate the associations between BMI, emotional motivation for food consumption, and health outcomes.

MATERIALS AND METHODS

"The Motivations for Food Choices" (EATMOT) questionnaire was used to assess the emotional components of food consumption in 9,036 individuals from 12 European countries. The multivariate analysis included linear and logistic regression to examine associations between variables.

RESULTS

Regression models confirmed associations between BMI, emotional motivation for food consumption (β = 0.13; p < 0.001), obesity (β = 0.35; p < 0.001), diabetes mellitus, and hypertension (β = 0.04; p < 0.001 for both). Using food as a coping mechanism for stress contributed to an increase in BMI [OR = 1.31 (95% CI 1.14-1.51); p < 0.001]. Emotional consolation was associated with a higher likelihood of an increased BMI [OR = 1.22 (95% CI 1.03-1.44); p = 0.020] and obesity [OR = 1.47 (95% CI 1.06-2.06); p = 0.022]. Participants with obesity had a greater likelihood of developing noncommunicable diseases, such as cardiovascular diseases [OR = 2.18 (95% CI 1.45-3.28); p < 0.001], diabetes mellitus [OR = 2.02 (95% CI 1.31-3.12); p = 0.001], hypercholesterolemia [OR = 1.62 (95% CI 1.13-2.32); p = 0.009], hypertension [OR = 1.85 (95% CI 1.36-2.52); p < 0.001], and gastric disorders [OR = 1.81 (95% CI 1.16-2.85); p = 0.010].

CONCLUSION

These results underscore the need for targeted public health interventions that address emotional eating behaviors and promote healthier coping strategies to mitigate the risk of obesity and related health complications.

Differences between the normal and perceived appropriate portion sizes of discretionary foods

BACKGROUND

There are limited data on the amount of discretionary foods that people normally consume and consider as appropriate at one eating occasion. This study aimed to provide an overview of the range and assess differences of the 'normal portion size' and 'perceived appropriate portion size' of energy-dense nutrient-poor discretionary foods among consumers aged 18-65 years.

METHODS

To measure normal and perceived appropriate portion sizes, a validated online image-series questionnaire consisting of eight successive portion size options for 15 discretionary foods was completed at two timepoints. Quantile regression models were used to estimate the ranges (lower boundary at 17th percentile, upper boundary at 83rd percentile) of normal and perceived appropriate portion sizes selected by two thirds of the study population. Models were adjusted for the effects of potential influencing factors including biological sex, age, usual physical activity level, cooking confidence, socio-economic status, body mass index, and baseline hunger levels.

RESULTS

A final sample of 295 participants were included in the analysis (51% females, mean age 39.5 ± 14.1 years). The normal portion sizes were significantly higher than the perceived appropriate portion sizes across all test foods, with the effects of sex, age, and BMI being significant for some foods.

CONCLUSION

The finding suggests that consumers would normally consume a portion size that was larger than what they perceive to be appropriate for discretionary foods. The estimated lower and upper boundaries would be valuable for the development of pragmatic public health messages to empower consumers towards better portion control.

Use of digital food records in clinical settings: lessons in translation from a randomised controlled trial

BACKGROUND

Digital food records offer efficiencies in collecting and assessing dietary information remotely; however, research into factors impacting their translation into clinical settings is limited.

METHODS

The study examined factors that may impact the integration of digital food records into clinical dietetic practice by assessing (1) the source and rate of data errors received, (2) the impact of dietitian-adjusted data on dietary variables and (3) the acceptance of use in a complex chronic condition cohort. Adults from specialist clinics enroled in a randomised controlled feasibility trial participated. Participants recorded their dietary intake using a mobile food diary application (Research Food diary, Xyris Software Pty Ltd.); it was analysed via electronic nutrition analysis software (FoodWorks, Xyris Software Pty Ltd.). Records were verified and corrected by a dietitian. Dietary variables assessed before (participant-unadjusted data) and after (dietitian-adjusted data) were compared by the Wilcoxon signed-rank test, Bland-Altman and Passing-Bablok analysis. Surveys and Interviews assessed participants'; acceptance of the mobile application's usability.

RESULTS

Errors appeared in 93% of records. Dietitian-adjusted median data were higher for most variables compared to participant-unadjusted median data (p < 0.05, median changes between 0.0% and 64.7%) of 59 participant records (median age 51 years, interquartile range 38-58). There was poor agreement between participant-unadjusted and dietitian-adjusted data for some dietary variables. Sixty-four percent surveyed (n = 32/50) found the app easy to use, whereas 29 interviews provided insights into facilitators and challenges of use.

CONCLUSIONS

Significant barriers to integrating digital food records into clinical settings exist requiring dietitian adjustment to correct errors which has major implications for estimates of diet quality and intake.

How big is too big? A qualitative study of discretionary food portion size norms among Australian consumers

OBJECTIVE

The high availability of energy-dense nutrient-poor discretionary foods in large serving and package sizes may have shifted portion size norms (described as a typical perception of how much people choose to eat from a given food at a single eating occasion) towards larger sizes. Few public health recommendations exist around appropriate discretionary food portion sizes. This qualitative study aimed to explore the underlying rationale of portion size norms of discretionary foods among Australian adults 18-65 years.

DESIGN

Four focus group sessions were conducted. Collected data were analysed using inductive thematic analysis.

SETTING

Focus groups were held online via Zoom between September and October 2023.

PARTICIPANTS

Thirty-four participants were recruited in the study (mean age 38 years, 19 females).

RESULTS

The key themes raised from inductive analysis were personal factors, eating context factors and food environment factors relevant to the portion size norms. A framework was established to illustrate the interaction across these themes during the conceptualisation of the norms. For serving size availability, consumers found that there were limited serving size choices when making portion size selections and lacked the knowledge and skills in portion control.

CONCLUSIONS

These findings highlight the need to make positive changes to the current food environment and develop relevant public health guidelines around appropriate portion sizes to promote healthier portion size norms and enable better portion control.

Differences in Portion Sizes in Brazil, France, and the USA

Portion size is recognized as a major determinant of food intake, at least over the short term, and could be related to overconsumption and obesity. In this study, we developed and evaluated a new visual measure of portion size (PS), examined whether the PS of chicken, ice cream, and soda varied among people in Brazil, France, and the USA, and tested whether PS was related to gender, body mass index, body weight, and socioeconomic status. We conducted a cross-sectional study using online convenience samples of university students (total N = 1391). Across all three foods, French personal and country PSs were significantly smaller than the other three countries. Estimated country PS was reliably larger than personal PS. Women's personal PSs were smaller than men's, but women's and men's estimates for country PS were similar. French personal and country PSs were the lowest. Some PSs had a weak but significant correlation with SES but were not significantly related to either weight or BMI. The study confirms French-American differences in personal PS and demonstrates that perceived norms correspond to individual PS.

Considerations for a protein-focused screening instrument in clinical nutrition assessment

Physiological stress during injury and surgery negatively impacts protein balance and muscle mass maintenance. Adequate perioperative protein intake may attenuate muscle atrophy to maintain and facilitate functional recovery, particularly in older adults; yet, screening tools routinely used in clinical settings do not specifically assess protein intake when assessing nutrition risk. Although assessing malnutrition is a priority, suboptimal protein intake in non-malnourished patients should also be identified given protein's critical role in muscle health. This opinion paper highlights the potential for using a clinically appropriate protein-focused screener for rapid and efficient characterization of protein intake.

Development and validation of an online tool to assess perceived portion size norms of discretionary foods

BACKGROUND

Perceived portion size norms (typical perception of how much of a given food individuals choose to eat at a single occasion) may have shifted towards larger sizes due to the ubiquity of large serving sizes. However, there is a lack of validated tools to assess such norms for energy-dense and nutrient-poor discretionary foods. This study aimed to develop and validate an online tool to examine the perceived portion size norms of discretionary foods.

METHODS

An online image-series tool of 15 commonly consumed discretionary foods was developed, with eight successive portion size options included for each food. Using a randomised-crossover design, adult consumers (18-65 years) completed the validation study in a laboratory session (April-May 2022) by reporting their perceived portion size norms for each food twice, once based on food images on a computer and another time based on equivalent real food portion size options at food stations in the laboratory. Agreement between methods for each test food was examined using cross-classification and intra-class correlation (ICC).

RESULTS

A sample of 114 subjects were recruited (mean age 24.8 years). Cross-classification indicated >90% of selections were matched in the same or adjacent portion size option. ICC was 0.85 across all foods, demonstrating a good level of agreement.

CONCLUSION

This novel online image-series tool developed to examine perceived portion size norms of discretionary foods showed good agreement with equivalent real food portion size options and may be valuable to investigate perceived portion size norms of common discretionary foods in future studies.