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Health Promotion Journal of Australia Health Promotion Journal of Australia Society
Journal of the Australian Health Promotion Association
COMMENT AND RESPONSE

Position paper on the need for portion-size education and a standardised unit of measurement

Tamara Bucher A B F , Megan E. Rollo A , Shamus P. Smith C , Moira Dean D , Hannah Brown A , Mingui Sun E and Clare Collins A
+ Author Affiliations
- Author Affiliations

A Nutrition and Dietetics, School of Health Sciences, Faculty of Health and Medicine, Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia.

B Institute of Food, Nutrition and Health, ETH Zürich, Universitätstrasse 22, 8092 Zürich, Switzerland.

C School of Electrical Engineering and Computer Science, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia.

D Institute for Global Food Security, School of Biological Sciences, Queen’s University Belfast, Belfast BT9 5AG, UK.

E Departments of Neurosurgery, Electrical and Computer Engineering, and Bioengineering, University of Pittsburgh, Pittsburgh, PA 15260, USA.

F Corresponding author. Email: tbucher@ethz.ch

Health Promotion Journal of Australia 28(3) 260-263 https://doi.org/10.1071/HE15137
Submitted: 26 November 2015  Accepted: 31 August 2016   Published: 13 October 2016

Abstract

Large portion sizes contribute to weight gain in western societies. Portion-size interventions, aids and education can be effective in helping prevent weight gain, but consumers are unsure what appropriate portions are and express confusion about existing guidelines. A lack of clarity about suggested serving size recommendations is a major barrier to food portion-size control. Therefore, standardised measurement units and unambiguous terminologies are required. This position paper summarises the evidence regarding the impact and importance of portion-size education and estimation, and outlines strategies for improving consumer understanding and application of this through the development of an international food measurement system and a range of appropriate portion control tools. In this position paper, the authors call for the standardisation of food volume measurement terminologies, units, implementation recommendations, as well as consumer education. The target audience for this paper includes nutrition and behavioural researchers, policy makers, and stakeholders who potentially influence and implement changes in national food measurement systems, which in turn impact on consumer choice.

Key words: food unit, serve size, standard serving size.


References

[1]  Young LR, Nestle M (2007) Portion sizes and obesity: responses of fast-food companies. J Public Health Policy 28, 238–48.
Portion sizes and obesity: responses of fast-food companies.Crossref | GoogleScholarGoogle Scholar | 17585324PubMed |

[2]  Hill JO, Peters JC (1998) Environmental contributions to the obesity epidemic. Science 280, 1371–4.
Environmental contributions to the obesity epidemic.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DyaK1cXjtlagsLc%3D&md5=afc4080d1f8311a2bff2a51e55cb87a2CAS | 9603719PubMed |

[3]  Young LR, Nestle M (2002) The contribution of expanding portion sizes to the US obesity epidemic. Am J Public Health 92, 246–9.
The contribution of expanding portion sizes to the US obesity epidemic.Crossref | GoogleScholarGoogle Scholar | 11818300PubMed |

[4]  Young LR, Nestle M (2003) Expanding portion sizes in the US marketplace: implications for nutrition counseling. J Am Diet Assoc 103, 231–40.
Expanding portion sizes in the US marketplace: implications for nutrition counseling.Crossref | GoogleScholarGoogle Scholar | 12589331PubMed |

[5]  Steenhuis IHM, Leeuwis FH, Vermeer WM (2010) Small, medium, large or supersize: trends in food portion sizes in The Netherlands. Public Health Nutr 13, 852–7.
Small, medium, large or supersize: trends in food portion sizes in The Netherlands.Crossref | GoogleScholarGoogle Scholar |

[6]  Nielsen SJ, Popkin BM (2003) Patterns and trends in food portion sizes, 1977–1998. JAMA 289, 450–53.
Patterns and trends in food portion sizes, 1977–1998.Crossref | GoogleScholarGoogle Scholar | 12533124PubMed |

[7]  Young LR, Nestle M (2007) Portion sizes and obesity: responses of fast-food companies. J Public Health Policy 28, 238–48.
Portion sizes and obesity: responses of fast-food companies.Crossref | GoogleScholarGoogle Scholar | 17585324PubMed |

[8]  Collins K, Watson JF, Collins CE (2014) Food and beverage portion sizes in Australian children: a secondary analysis of 1995 and 2007 national data. BMC Public Health 14, 517
Food and beverage portion sizes in Australian children: a secondary analysis of 1995 and 2007 national data.Crossref | GoogleScholarGoogle Scholar | 24886094PubMed |

[9]  Nestle M. Food politics: how the food industry influences nutrition and health. Revised and expanded 10th anniversary edition. Berkeley: University of California Press; 2013.

[10]  Wansink B, van Ittersum K (2007) Portion size me: downsizing our consumption norms. J Am Diet Assoc 107, 1103–6.
Portion size me: downsizing our consumption norms.Crossref | GoogleScholarGoogle Scholar | 17604738PubMed |

[11]  Rolls BJ, Morris EL, Roe LS (2002) Portion size of food affects energy intake in normal-weight and overweight men and women. Am J Clin Nutr 76, 1207–13.

[12]  Steenhuis IHM, Vermeer WM (2009) Portion size: review and framework for interventions. Int J Behav Nutr Phy. 6, 58
Portion size: review and framework for interventions.Crossref | GoogleScholarGoogle Scholar |

[13]  Rolls BJ (2014) What is the role of portion control in weight management? Int J Obes 38, S1–8.
What is the role of portion control in weight management?Crossref | GoogleScholarGoogle Scholar |

[14]  Livingstone MB, Pourshahidi LK (2014) Portion size and obesity. Adv Nutr 5, 829–34.
Portion size and obesity.Crossref | GoogleScholarGoogle Scholar | 25398749PubMed |

[15]  Fisher JO, Kral TV (2008) Super-size me: portion size effects on young children’s eating. Physiol Behav 94, 39–47.
Super-size me: portion size effects on young children’s eating.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BD1cXkslejs74%3D&md5=5029ea2762f1593828613887770198e4CAS | 18155736PubMed |

[16]  Ello-Martin JA, Ledikwe JH, Rolls BJ (2005) The influence of food portion size and energy density on energy intake: implications for weight management. Am J Clin Nutr 82, 236S–41S.

[17]  Rodrigues AG, Proenca RP, Calvo MC, Fiates GM (2012) Overweight/obesity is associated with food choices related to rice and beans, colors of salads, and portion size among consumers at a restaurant serving buffet-by-weight in Brazil. Appetite 59, 305–11.
Overweight/obesity is associated with food choices related to rice and beans, colors of salads, and portion size among consumers at a restaurant serving buffet-by-weight in Brazil.Crossref | GoogleScholarGoogle Scholar | 22634196PubMed |

[18]  Wansink B. Mindless eating: why we eat more than we think. New York: Bantam; 2007.

[19]  Rozin P, Ashmore M, Markwith M (1996) Lay American conceptions of nutrition: dose insensitivity, categorical thinking, contagion, and the monotonic mind. Health Psychol 15, 438–47.
Lay American conceptions of nutrition: dose insensitivity, categorical thinking, contagion, and the monotonic mind.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK2s7ivFCitA%3D%3D&md5=12b7681aa1ed4209ce6a272be94d06ddCAS | 8973924PubMed |

[20]  Chernev A (2011) The dieter’s paradox. J Consum Psychol 21, 178–83.
The dieter’s paradox.Crossref | GoogleScholarGoogle Scholar |

[21]  Chandon P, Wansink B (2007) Is obesity caused by calorie underestimation? A psychophysical model of meal size estimation. J Mark Res 44, 84–99.
Is obesity caused by calorie underestimation? A psychophysical model of meal size estimation.Crossref | GoogleScholarGoogle Scholar |

[22]  Sütterlin B, Siegrist M (2015) Simply adding the word “fruit” makes sugar healthier: the misleading effect of symbolic information on the perceived healthiness of food. Appetite 95, 252–61.
Simply adding the word “fruit” makes sugar healthier: the misleading effect of symbolic information on the perceived healthiness of food.Crossref | GoogleScholarGoogle Scholar | 26184340PubMed |

[23]  Spence M, Livingstone MB, Hollywood LE, Gibney ER, O’Brien SA, Pourshahidi LK, et al (2013) A qualitative study of psychological, social and behavioral barriers to appropriate food portion size control. Int J Behav Nutr Phys Act 10, 92
A qualitative study of psychological, social and behavioral barriers to appropriate food portion size control.Crossref | GoogleScholarGoogle Scholar | 23915381PubMed |

[24]  Australian Government, National Health and Medical Research Council (NHMRC). Australian guide to healthy eating: serve sizes. 2015. Available from: https://www.eatforhealth.gov.au/food-essentials/how-much-do-we-need-each-day/serve-sizes [Verified 7 March 2016].

[25]  Food Standards Australia New Zealand (FSANZ). Nutrition information panels. 2015. Available from: http://www.foodstandards.gov.au/consumer/labelling/panels/Pages/default.aspx [Verified 21 February 2016].

[26]  UK Department of Health and Food Standards Agency. Guide to creating a front of pack (FoP) nutrition label for pre-packed products sold through retail outlets. 2013. Available from: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/300886/2902158_FoP_Nutrition_2014.pdf [Verified 13 September 2016].

[27]  Poelman MP, Eyles H, Dunford E, Schermel A, L’Abbe MR, Neal B, et al (2016) Package size and manufacturer-recommended serving size of sweet beverages: a cross-sectional study across four high-income countries. Public Health Nutr 19, 1008–16.
Package size and manufacturer-recommended serving size of sweet beverages: a cross-sectional study across four high-income countries.Crossref | GoogleScholarGoogle Scholar | 26148431PubMed |

[28]  U.S. Food and Drug Administration. Guidance for industry: guidelines for determining metric equivalents of household measures. 1993. Available from: http://www.fda.gov/food/guidanceregulation/guidancedocumentsregulatoryinformation/ucm063102.htm [Verified 14 September 2015].

[29]  Collins CE, Bucher T, Taylor A, Pezdirc K, Lucas H, Watson J, et al (2015) How big is a food portion? A pilot study in Australian families. Health Promot J Austr 26, 83–8.
How big is a food portion? A pilot study in Australian families.Crossref | GoogleScholarGoogle Scholar | 25917272PubMed |

[30]  Hannah B. The influence of health and energy information on consumer’s portion size perceptions. Honours Thesis, University of Newcastle, Australia, 2015.

[31]  Nørnberg TR, Houlby L, Jørgensen LN, He C, Pérez-Cueto FJ (2014) Do we know how much we put on the plate? Assessment of the accuracy of self-estimated versus weighed vegetables and whole grain portions using an intelligent buffet at the FoodScape Lab. Appetite 81, 162–7.
Do we know how much we put on the plate? Assessment of the accuracy of self-estimated versus weighed vegetables and whole grain portions using an intelligent buffet at the FoodScape Lab.Crossref | GoogleScholarGoogle Scholar | 24928435PubMed |

[32]  Small L, Lane H, Vaughan L, Melnyk B, McBurnett D (2013) A systematic review of the evidence: the effects of portion size manipulation with children and portion education/training interventions on dietary intake with adults. Worldviews Evid Based Nurs 10, 69–81.
A systematic review of the evidence: the effects of portion size manipulation with children and portion education/training interventions on dietary intake with adults.Crossref | GoogleScholarGoogle Scholar | 22703240PubMed |

[33]  Bucher T, Siegrist M, van der Horst K (2014) Vegetable variety: an effective strategy to increase vegetable choice in children. Public Health Nutr 17, 1232–6.
Vegetable variety: an effective strategy to increase vegetable choice in children.Crossref | GoogleScholarGoogle Scholar | 24107607PubMed |

[34]  Bucher T, van der Horst K, Siegrist M (2011) Improvement of meal composition by vegetable variety. Public Health Nutr 14, 1357–63.
Improvement of meal composition by vegetable variety.Crossref | GoogleScholarGoogle Scholar | 21557868PubMed |

[35]  Almiron-Roig E, Palla L, Guest K, Ricchiuti C, Vint N, Jebb SA, et al (2013) Factors that determine energy compensation: a systematic review of preload studies. Nutr Rev 71, 458–73.
Factors that determine energy compensation: a systematic review of preload studies.Crossref | GoogleScholarGoogle Scholar | 23815144PubMed |

[36]  English L, Lasschuijt M, Keller KL (2015) Mechanisms of the portion size effect. What is known and where do we go from here? Appetite 88, 39–49.
Mechanisms of the portion size effect. What is known and where do we go from here?Crossref | GoogleScholarGoogle Scholar | 25447010PubMed |

[37]  Ball GD, Friedman A (2010) Dice, golf balls, and CDs: assumptions about portion size measurement aids. Can J Diet Pract Res 71, 146–9.
Dice, golf balls, and CDs: assumptions about portion size measurement aids.Crossref | GoogleScholarGoogle Scholar | 20825698PubMed |

[38]  Poelman MP, Steenhuis IH, de Vet E, Seidell JC (2013) The development and evaluation of an Internet-based intervention to increase awareness about food portion sizes: a randomized, controlled trial. J Nutr Educ Behav 45, 701–7.
The development and evaluation of an Internet-based intervention to increase awareness about food portion sizes: a randomized, controlled trial.Crossref | GoogleScholarGoogle Scholar | 23877055PubMed |

[39]  Poelman MP, de Vet E, Velema E, de Boer MR, Seidell JC, Steenhuis IH (2015) PortionControl@HOME: results of a randomized controlled trial evaluating the effect of a multi-component portion size intervention on portion control behavior and body mass index. Ann Behav Med 49, 18–28.
PortionControl@HOME: results of a randomized controlled trial evaluating the effect of a multi-component portion size intervention on portion control behavior and body mass index.Crossref | GoogleScholarGoogle Scholar | 25142041PubMed |