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Carruba MO, Ragni M, Ruocco C, Aliverti S, Silano M, Amico A, Vaccaro CM, Marangoni F, Valerio A, Poli A, Nisoli E. Role of Portion Size in the Context of a Healthy, Balanced Diet: A Case Study of European Countries. Int J Environ Res Public Health 2023; 20:5230. [PMID: 36982138 PMCID: PMC10049364 DOI: 10.3390/ijerph20065230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 03/10/2023] [Accepted: 03/15/2023] [Indexed: 06/18/2023]
Abstract
Over the past decades, a generalised increase in food portion sizes has probably contributed to the growing global obesity epidemic. Increasing awareness of appropriate portion sizes could contribute to reversing this trend through better control of calorie intake. In this study, a comparison of standard portion sizes in European countries for various food categories shows a wide variability of their importance for food, nutrient, and energy consumption according to government and institutional websites. On the other hand, the overall averages appear to be largely in line with the values indicated by the Italian Society of Human Nutrition, which is the most comprehensive and detailed document among those evaluated. The exceptions are milk and yoghurt, for which the reference portions in Europe are generally higher, and vegetables and legumes, for which portions are smaller than those reported in the Italian document. Moreover, the portion sizes of staple foods (e.g., pasta and potatoes) vary according to different food traditions. It is reasonable to consider that the creation of harmonised standard reference portions common to the European countries, based on international guidelines and scientific evidence, would significantly contribute to consumers' nutritional education and ability to make informed choices for a healthy diet.
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Affiliation(s)
- Michele O. Carruba
- Center for Study and Research on Obesity, Department of Biomedical Technology and Translational Medicine, University of Milan, Via Vanvitelli, 32, 20129 Milan, Italy; (M.O.C.)
| | - Maurizio Ragni
- Center for Study and Research on Obesity, Department of Biomedical Technology and Translational Medicine, University of Milan, Via Vanvitelli, 32, 20129 Milan, Italy; (M.O.C.)
| | - Chiara Ruocco
- Center for Study and Research on Obesity, Department of Biomedical Technology and Translational Medicine, University of Milan, Via Vanvitelli, 32, 20129 Milan, Italy; (M.O.C.)
| | - Sofia Aliverti
- Nutrition Foundation of Italy, Viale Tunisia, 38, 20124 Milan, Italy
| | - Marco Silano
- Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161 Rome, Italy
| | - Andrea Amico
- Health and Welfare Unit, Censis Foundation, Piazza di Novella, 2, 00199 Rome, Italy
| | - Concetta M. Vaccaro
- Health and Welfare Unit, Censis Foundation, Piazza di Novella, 2, 00199 Rome, Italy
| | - Franca Marangoni
- Nutrition Foundation of Italy, Viale Tunisia, 38, 20124 Milan, Italy
| | - Alessandra Valerio
- Department of Molecular and Translational Medicine, Brescia University, Viale Europa, 11, 25123 Brescia, Italy
| | - Andrea Poli
- Nutrition Foundation of Italy, Viale Tunisia, 38, 20124 Milan, Italy
| | - Enzo Nisoli
- Center for Study and Research on Obesity, Department of Biomedical Technology and Translational Medicine, University of Milan, Via Vanvitelli, 32, 20129 Milan, Italy; (M.O.C.)
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Flieh SM, Miguel-Berges ML, González-Gil EM, Gottrand F, Censi L, Widhalm K, Manios Y, Kafatos A, Molnár D, Dallongeville J, Stehle P, Gonzalez-Gross M, Marcos A, De Henauw S, Molina-Hidalgo C, Huybrechts I, Moreno LA. The Association between Portion Sizes from High-Energy-Dense Foods and Body Composition in European Adolescents: The HELENA Study. Nutrients 2021; 13:954. [PMID: 33809476 PMCID: PMC7998698 DOI: 10.3390/nu13030954] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 03/05/2021] [Accepted: 03/12/2021] [Indexed: 02/06/2023] Open
Abstract
Obesity prevalence has been simultaneously increasing with high consumption of large food portion sizes (PS). However, there is scarce information on PS of energy-dense (ED) foods as a potential risk factor of obesity in adolescents. In the present study, we investigate the association between the PS of the most ED foods and body composition. A sample of 1889 adolescents (54.4% females) from the Healthy Lifestyle in Europe by Nutrition in Adolescence cross-sectional multicenter study (HELENA-CSS) study were included. Most ED foods (e.g., cheese) were selected according to higher fat and/or sugar content and low fiber and water. Linear and ordinal logistic regression models were adjusted for age, physical activity, total energy intake (TEI), and socioeconomic status (SES). Analysis was performed both in those adolescents reporting plausible energy intake according to the approach of Goldberg et al. and in the whole sample. In male plausible reporters, PS from "breakfast cereals" showed a significant and positive association with BMI (β = 0.012; 0.048). PS from "carbonated soft drinks" in males (OR = 1.001; 95% CI 1.000; 1.002) and "bread and rolls" in females (OR = 1.002; 95% CI 1.000; 1.004) were associated with higher probability of having obesity, while "sweet bakery products" were associated with lower probability of having obesity (OR = 0.996; 95% CI 0.991; 0.999) in females. The present study suggests association between PS of ED foods and obesity in European adolescents. Prospective studies are needed to examine the effect of prolonged exposure to large PS and obesity development.
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Affiliation(s)
- Sondos M. Flieh
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain; (S.M.F.); (M.L.M.-B.); (L.A.M.)
| | - María L. Miguel-Berges
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain; (S.M.F.); (M.L.M.-B.); (L.A.M.)
- Instituto Agroalimentario de Aragón (IA2), 50013 Zaragoza, Spain
| | - Esther M. González-Gil
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain; (S.M.F.); (M.L.M.-B.); (L.A.M.)
- Instituto Agroalimentario de Aragón (IA2), 50013 Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), 50009 Zaragoza, Spain
- Center of Biomedical Research (CIBM), Department of Biochemistry and Molecular Biology II, Instituto de Nutrición y Tecnología de los Alimentos, University of Granada, 18071 Granada, Spain
| | - Frédéric Gottrand
- CHU Lille, University Lille, INSERM U1286 Infinite, F-59000 Lille, France;
| | - Laura Censi
- Council for Agricultural Research and Economics, Research Centre for Food and Nutrition, 00178 Roma, Italy;
| | - Kurt Widhalm
- Department of Gastroenterology and Hepatology, Medical University of Vienna, 1090 Vienna, Austria;
- Austrian Academic Institute for Clinical Nutrition, A-3100 Vienna, Austria
| | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17671 Athens, Greece;
- Institute of Agri-Food and Life Sciences, Hellenic Mediterranean University Research Centre, 71410 Heraklion, Greece
| | - Anthony Kafatos
- Faculty of Medicine, University of Crete, GR-71003 Crete, Greece;
| | - Dénes Molnár
- Department of Pediatrics, Medical School, University of Pécs, H-7624 Pécs, Hungary;
| | - Jean Dallongeville
- Department of Epidemiology and Public Health, Institut Pasteur de Lille, 59000 Lille, France;
| | - Peter Stehle
- Department of Nutrition and Food Sciences, University of Bonn, D-53115 Bonn, Germany;
| | - Marcela Gonzalez-Gross
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain;
- ImFINE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | - Ascensión Marcos
- Inmunonutrition Research Group, Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC), 28040 Madrid, Spain;
| | - Stefaan De Henauw
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium;
| | - Cristina Molina-Hidalgo
- EFFECTS 262 Department of Medical Physiology, School of Medicine, University of Granada,18071 Granada, Spain;
| | - Inge Huybrechts
- International Agency for Research on Cancer (IARC), 69372 Lyon, France;
- Department of Public Health, Ghent University, 9000 Ghent, Belgium
| | - Luis A. Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain; (S.M.F.); (M.L.M.-B.); (L.A.M.)
- Instituto Agroalimentario de Aragón (IA2), 50013 Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), 50009 Zaragoza, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain;
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Rippin HL, Hutchinson J, Jewell J, Breda JJ, Cade JE. Portion Size of Energy-Dense Foods among French and UK Adults by BMI Status. Nutrients 2018; 11:nu11010012. [PMID: 30577527 PMCID: PMC6356251 DOI: 10.3390/nu11010012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 12/14/2018] [Accepted: 12/17/2018] [Indexed: 12/14/2022] Open
Abstract
Evidence links consumed food portion size (FPS) and excess weight via increased energy intake. Policies to regulate on-pack serving sizes may be needed; determining consumed FPS of popular energy-dense foods for normal weight and overweight or obese (OWOB) adults, as reported here, may provide evidence to assist this. Data were analysed from national cross-sectional surveys, the French Étude Individuelle Nationale des Consommations Alimentaires2 2005⁻2007 (n = 2117), and UK National Diet and Nutrition Survey 2008⁻2014 (n = 3413). The impact of body mass index (BMI) on FPS is also investigated, adjusting for age, sex and under-reporting. Effects of under-reporting on relationships between FPS and BMI; and BMI on consumption frequency (UK only) were explored. OWOB reported larger FPS than normal-weight individuals in many, but not all food subgroups; however, there were only two significant FPS differences. In adjusted analyses, French individuals consumed 1.0 g (99% CI 0.01⁻2.1 p = 0.01) greater FPS in cakes for 1 point difference in BMI. 'Other cakes' and 'dark chocolate' were also significantly positively associated with BMI. High-fat bar snacks, but no UK main food groups, were positively associated with BMI. There was limited evidence of links between FPS and BMI in UK and French national cross-sectional data, possibly due to data limitations such as under-reporting. Future work should explore this and relationships between consumed FPS and on-pack suggested serving sizes to provide evidence to assist obesity-prevention policies.
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Affiliation(s)
- Holly L Rippin
- Nutritional Epidemiology Group (NEG), School of Food Science and Nutrition, University of Leeds, Leeds LS2 9JT, UK.
| | - Jayne Hutchinson
- Nutritional Epidemiology Group (NEG), School of Food Science and Nutrition, University of Leeds, Leeds LS2 9JT, UK.
| | - Jo Jewell
- Division of Noncommunicable Diseases and Promoting Health through the Life-Course, World Health Organization Regional Office for Europe, UN City, Marmorvej 51, DK-2100 Copenhagen, Denmark.
| | - Joao J Breda
- Division of Noncommunicable Diseases and Promoting Health through the Life-Course, World Health Organization Regional Office for Europe, UN City, Marmorvej 51, DK-2100 Copenhagen, Denmark.
| | - Janet E Cade
- Nutritional Epidemiology Group (NEG), School of Food Science and Nutrition, University of Leeds, Leeds LS2 9JT, UK.
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Biltoft-Jensen A, Holmgaard Nielsen T, Hess Ygil K, Christensen T, Fagt S. Accuracy of food photographs for quantifying food servings in a lunch meal setting among Danish children and adults. J Hum Nutr Diet 2017; 31:131-140. [PMID: 28656744 DOI: 10.1111/jhn.12490] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Visual aids, such as food photographs, are widely used in estimating food quantities in dietary surveys. The present study aimed to assess how accurately Danish adults and children can estimate food portion sizes using 37 series of photographs illustrating four to six different portion sizes under real-life conditions; determine whether adults were more accurate than children; and estimate the error caused by using portion size photographs to estimate weights of foods consumed in macronutrient calculation. METHODS Six hundred and twenty-two adults and 109 children were recruited in three workplace canteens and in two schools, respectively, to estimate their lunchtime portions based on photographs. Participants were instructed to keep the foods separated on their plate when taking lunch. Participants thereafter estimated their own portions by looking at the relevant series of photographs. The actual food portions were then weighed. RESULTS The proportion of correct estimations was 42% overall (range 19-77%). The mean difference (%) between estimated and actual weight was 17% (range 1-111%). Small portion size photographs were more often used correctly compared to larger portion photographs. Children had as many correct estimations as adults, although they overestimated portions more. Participants using fractions of (or more than) one photograph to estimate the portion of a food had significantly larger errors. When calculating the macronutrient content of a weekly menu using the estimated portion sizes, protein had the largest error (29%). CONCLUSIONS When used in a real-life situation, the portion size photographs validated in the present study showed a certain inaccuracy compared to the actual weights.
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Affiliation(s)
- A Biltoft-Jensen
- Division for Risk Assessment and Nutrition, The National Food Institute, Technical University of Denmark, Søborg, Denmark
| | - T Holmgaard Nielsen
- Division for Risk Assessment and Nutrition, The National Food Institute, Technical University of Denmark, Søborg, Denmark
| | - K Hess Ygil
- Division for Risk Assessment and Nutrition, The National Food Institute, Technical University of Denmark, Søborg, Denmark
| | - T Christensen
- Division for Risk Assessment and Nutrition, The National Food Institute, Technical University of Denmark, Søborg, Denmark
| | - S Fagt
- Division for Risk Assessment and Nutrition, The National Food Institute, Technical University of Denmark, Søborg, Denmark
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