Portion Sizes Eventually Add Up

Last Editorial Review: 1/31/2005

Cleaning your plate can pack on the pounds.

By Neil Osterweil
WebMD Weight Loss Clinic - Feature

Reviewed By Brunilda Nazario, MD

If you are what you eat, then there's a good chance that you are super-sized.

When McDonald's recently announced that it would be phasing out its "super size" French fries and soft drink portions in its U.S. fast food outlets, nutritionists and diet experts said, "It's about time."

According to a nutritional chart available for download on the company's web site, a 7-ounce portion of super size French fries supplies 610 calories, 260 of which come from fat. The 29 grams of fat the fries contain represents 45% of the daily value recommended by the FDA, based on a 2,000-calorie-per-day diet.

But even when the mega-sized portions disappear from the menu, you'll still be able to scarf down a bag of large fries at 540 calories of which almost half of theses calories are from fat (26 grams of fat and 40% of the total daily value). Add a Big Mac® (600 calories, 33 grams of fat, 51% of daily value) and a large Coca-Cola Classic® (310 calories, 86 grams carbohydrates, 29% of daily value) and you're set for the day.

While nutritionists and diet experts generally applaud McDonald's move away from bloated meals, some say that it may be a case of closing the barn door after the horse has bolted.

"In a sense, does a move like that really make a difference? If you can buy small, medium, and large, you can buy two smalls or two mediums; I'm not sure there's that much of a difference," says Alice Lichtenstein, DSc, professor of nutrition science and policy at the Friedman School of Nutrition Science and Policy at Tufts University in Boston.

It All Adds Up

There's little doubt that portion sizes -- along with American waistlines -- have ballooned over the last several decades. In a study published in the American Journal of Public Health in 2002, Lisa R. Young, PHD, MD, and Marion Nestle, PhD, MPH write that "marketplace food portions are consistently larger than they were in the past as well as considerably larger than federal standard portion sizes. These observations suggest a need for greater attention to food portion size as a factor in energy intake [calorie] and weight management. A recent survey reports that Americans tend to ignore serving size when they are attempting to maintain body weight."

In an interview with WebMD, Nestle, professor and chair of the department of nutrition, Food Studies & Public Health at New York University, says that McDonald's is at least taking a step in the right direction.

"I think what happened over time was that people got accustomed to larger portions, and think that reductions in portions is cheating, and so a small reduction, like the one that McDonald's has in mind, is really not a bad idea," Nestle tells WebMD. "I do not think that people will just buy more to make up the difference -- that's never been the case. It's always been the case that people eat what's put in front of them, and the difference between 7 and 6.2 ounces is probably three potatoes, not very much. I don't think anybody will notice."

Studies have consistently shown that people who are served larger portions will eat larger portions, agrees Barbara Rolls, PhD, who has made a career out of studying how food and liquid intake relate to obesity, eating disorders, and aging. She and her colleagues have performed studies showing that people who are fed increasingly larger portions of food on successive days -- without being told that the portions have been super-sized -- tend to eat the entire larger portion.

But most of us aren't born overeaters, suggests Rolls, professor of nutrition at Penn State University in University Park, Pa. She conducted a study in which 3-year-old and 5-year-old children were given three different-sized portions of macaroni and cheese on different days. "In the young kids, portion size didn't affect how much they were eating, but by the time the kids are 5 years old, the bigger the portion, the more they eat," Rolls said at a recent Harvard School of Public Health symposium on the science of obesity.

Eating Patterns Start Early

Lictenstein notes that "there's a tremendous amount of data that eating patterns are developed relatively young, and that's why you tend to see this tracking, -- not always, but you frequently see this tracking -- of chubbier parents having chubbier kids, and in some cases there may be a genetic basis, but for a lot of it, it probably is environmental."

Rolls tells WebMD that getting people to change the amount or volume of food they eat is a challenge. "To get people who are used to these huge portions back in sync with what people should be eating is very difficult in adults, and that's why I think reducing the calorie density is a more workable solution."

She explains that by adding relatively small amounts of foods that are high in water content and fiber to standard dishes, people can still eat a satisfying volume of food but ultimately take in fewer calories.

Surprisingly, many people don't realize that larger portions mean more calories, Nestle tells WebMD. "Everybody laughs when I say that, but I swear to you that it's not intuitively obvious. There's something about a container or a serving or an amount that's put in front of you that doesn't get computed as larger or smaller or anything like that. Even when the package sizes are lined up; people don't think of them as having more calories."

She applauds the FDA's suggestion to change labeling on food packages to list the entire amount of calories in, say, a 20-ounce bottle of soda, typically sold in school vending machines. "That is 110 calories per serving with two-and-a-half servings in the bottle, and so the proposed label is instead of having 110 calories, to have 275 calories on the label. It's very shocking to look at it, even for somebody like me. Certainly soft drinks aren't shared, ever, and one of the things that school's complain about is that kids carry the bottles around with them all day," Nestle says.

Lichtenstein suggests that if food were labeled by the amount of calories per dollar, people might also have incentive to think about how much they're eating. "From what I understand, it doesn't cost the food marketer that much to increase the actual portion because there's a fixed overhead cost and fixed packaging costs, and that the real cost is in the initial providing of the food, which is why when you buy a big box of something it's cheaper per pound than a small box of something. That economic incentive is going to be there."

Published March 22, 2004.

SOURCES: Alice Lichtenstein, DSc, professor, nutrition science and policy, Friedman School of Nutrition Science and Policy, Tufts University, Boston. Marion Nestle, PhD, MPH, professor and chair, department of nutrition, Food Studies & Public Health, New York University. Barbara Rolls, PhD, professor of nutrition, Penn State University, University Park, Pa. Young LR and Nestle M. American Journal of Public Health, February 2002; pp 246-249. McDonald's Corporation. FDA Center for Food Safety and Applied Nutrition.

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