Portion Size & Energy Intake: A key nutritional concept we must now understand to address obesity

Lead Research Organisation: University of Liverpool
Department Name: Institute of Psychology Health & Society

Abstract

Rises in obesity have been caused by increases in energy intake and a key environmental factor which may responsible for this is portion size. Over the last thirty years portion sizes for a wide variety of foods have increased. This is a cause for concern because experimental data shows that people 'clear their plate' and eat most of the food they are served. To date, we have very convincing acute laboratory data showing that portion size is likely to be a key driver of energy intake; the amount of energy we are served at a meal or provided in a food portion influences how much energy we consume. Because of this, targeting reductions to portion size could be a key approach to tackling obesity and recently commissioned public health reports support this view.
However, we currently lack a theoretical model which is able to 1) explain why portion size exerts such a strong effect on energy intake and, 2) identify the magnitude of reductions to portion size we can make to promote reliable long-term reductions to energy intake. This is a major stumbling block because before we can be confident that exploiting portion size will help to tackle obesity, we need to understand why portion size influences energy intake and how to reformulate portion sizes. Recent research has shown that it is critical that reductions made to portion size are informed by a theoretical model, because if not, it is likely that any energy reductions made could be cancelled out by later compensatory eating.
The aim of the present research is to develop and test a theoretical model to explain the effect that portion size has on energy intake, before applying this knowledge to test how we can reduce portion sizes to promote reliable and sustained reductions to energy intake. Our theoretical model builds on an established framework and is based on the premise that when presented with a food portion, individuals make a simple perceptual categorisation of the portion being either 'normal' or abnormal in size. If a portion is categorised as being 'normal' a consumer would be likely to eat the majority of the food provided. Although this kind of perceptual categorisation is cognitively efficient, a relatively wide range of portion sizes appear 'normal'. We predict that this causes any increases or decreases to portion sizes which sit inside this 'normal range' to have marked effects on energy intake. Thus, our proposed model attempts to explain why portion size can exert such a strong effect on intake for a variety of foods, with consumers still believing they have eaten a 'normal' sized meal. This research grant will empirically test our proposed theory and examine the effect of reducing portion size on energy balance. In doing so, this work brings together experts in the fields of appetite, health psychology, visual perception and public health, in order to understand portion size and energy intake. Critically, our theoretical model suggests that there are likely to be boundary conditions which determine when a decrease to portion size will cease to have a reliable effect on energy intake. By testing these boundary conditions we will be in a unique position to examine the size of portion size reductions required to promote a sustained decrease in energy intake. In doing so we will generate important knowledge about how we can go about reformulating portion sizes for public health benefit.
By the end of the three year programme we will have tested a theoretical account of why portion size influences energy intake and applied this knowledge to test whether it is possible to use portion size principles to promote sustained reductions to energy intake. These novel insights will have direct relevance to the food industry and public health initiatives which aim to make reductions to portion size in order to help tackle the widespread obesity problem.

Technical Summary

A number of studies show that portion size can have a significant effect on energy consumption; when served larger portions we tend to consume more food. Although reducing portion sizes could be an effective public health approach to tackling weight gain and obesity, we currently lack a psychological theory which a) explains why portion size can exert such a strong influence on energy intake & b) can identify the boundary conditions which determine the magnitude of portion size reductions which will cause sustained and reliable decreases to energy intake. This is problematic because if we do not understand why portion size influence intake, intervention efforts to reduce portion size may fail, due to portion size energy reductions being cancelled out by later compensatory eating.
The aim of this work is to test a proposed theoretical model of the effect that portion size has on energy intake. Our theoretical model builds on visual perception research and is based on the premise that portion sizes are categorically perceived; in other words, when provided with a food portion, individuals make a simple perceptual categorisation of the portion being either 'normal' or abnormal in size. Consistent with previous work, we predict that if a portion is perceived as being 'normal' an individual would be likely to eat the majority of the food provided. A key point of our proposed theory is that although this kind of perceptual categorisation is cognitively efficient, a relatively wide range of portion sizes appear 'normal'. This in turn results in marked effects on energy intake, providing that any increase or decrease to portion size falls inside of a food's 'normal range'. We will test this theory across three laboratory studies. Guided by these insights we will then conduct a large scale 7-day energy balance experiment, in which we examine the size of portion size reductions required to promote reliable and long-term decreases to energy intake.

Planned Impact

Excess energy consumption and weight gain are major causes for concern, because of the large effect that obesity continues to have on the economy and public health. The present work provides critical information about an approach which could be used to directly address overconsumption and obesity on a population level. To date, we have a very poor understanding of why portion size influences energy intake or how much portion size can be reduced by in order to promote sustained reductions to energy intake. The present research will provide novel information which addresses these needs.
The influence that portion size has on energy intake and its potential public health application has been studied as far afield as America, Europe, Australia and Asia. Thus, as this research programme proposes a novel theoretical model of the influence that portion size has on energy intake, it has potential to benefit the work of scientists across the world. In particular, this research grant will provide critical information about how to reformulate portion size in a way that promotes sustained reductions to energy intake. Given the applied relevance of this work we also envisage it will impact on a wide spectrum of obesity and public health researchers, who will be able to use this new knowledge to guide future intervention efforts against obesity.
Now that we know the influence that overconsumption and weight gain have on health and well-being, there is a pressing need to reduce energy intake at a population level. Focusing on portion size is a potentially far reaching approach. Our work will act as exemplar of how we can use methods from different disciplines (e.g. visual science and feeding behaviour) to understand a complex behaviour and then use this information to start to examine how we can attempt to improve public health. Thus, our findings have potential to be far reaching in the long term, in terms of improving population health and the drain that obesity has on the economy.
As we believe the longer-term implications of this work will have potential to benefit nutrition and public health, a strong component of this project is ensuring that we actively engage with the general public and the types of bodies able to harness portion size principles to improve public health. We have planned a dissemination event to target key stakeholders at the end of the programme and we will supplement this with events and activities targeted at the general public (e.g. British Science Festival). Supplementary dissemination activities will also ensure we have regular communication with key stakeholders. Thus, our work will be delivered in way that maximises its potential impacts on traditional academic circles, public health initiatives and the food industry.

Publications

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Haynes A (2018) A systematic review of the relationship between weight status perceptions and weight loss attempts, strategies, behaviours and outcomes. in Obesity reviews : an official journal of the International Association for the Study of Obesity

 
Description Submission of evidence to Department of Health and Social Care
Geographic Reach National 
Policy Influence Type Contribution to a national consultation/review
Impact We presented and formally submitted evidence from our MRC funded research to the Department of Health and Social Care's consultation on a new public health policy on mandating calorie labelling for food and drink sold out of the home. Our research has had immediate impact (it is being used by the Department in their policy specification) and the longer-term impacts of the policy (e.g. benefit to Public Health) will be measurable after the policy has come into effect.
URL https://www.gov.uk/government/consultations/calorie-labelling-for-food-and-drink-served-outside-of-t...
 
Description Starter grant
Amount € 1,365,346 (EUR)
Organisation European Research Council (ERC) 
Sector Public
Country Belgium
Start 01/2019 
End 12/2023
 
Description Article about our research for a food industry specialist interest publication 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Industry/Business
Results and Impact Our MRC funded research highlights how the food industry could benefit public health by reducing the calorie content of commercially provided foods. We wrote a piece highlighting our findings and their industry relevance for trade magazine 'The Grocer', which has a large international readership.
Year(s) Of Engagement Activity 2019
URL https://www.thegrocer.co.uk/buying-and-supplying/health/how-smaller-portions-can-become-the-new-norm...
 
Description Conference presentation - UK Society for Behavioural Medicine 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Other audiences
Results and Impact We presented the results of our first study conducted during the grant to delegates at the UK society for behavioural medicine conference, December 2016. This allowed us to raise awareness about our ongoing work to our academic colleagues in the UK and receive feedback on the work to date.
Year(s) Of Engagement Activity 2016
 
Description Dissemination event in local community (MRC science festival) 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Public/other audiences
Results and Impact MRC festival of science. We communicated our ongoing research to the general public at a local museum. Over 100 families visited on the day and participated in interactive activities with our research team. We also discussed our research and answered questions.
Year(s) Of Engagement Activity 2016
 
Description International conference presentation - Society for the Study of Ingestive Behavior, Porto 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact We gave an oral presentation of our grant work at the Society for the Study of Ingestive Behavior international conference in Porto, Portugal. There were approximately 100 delegates at our presentation. The presentation sparked discussion and a number of researchers requested further information.
Year(s) Of Engagement Activity 2016
 
Description Invited presentation 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Other audiences
Results and Impact This one-day workshop brought together nutrition and public health professionals, industry members and academics. The aim was to evaluate and discuss ways to implement the downsizing of food product portion sizes to address population level nutrition and obesity. I was an invited keynote speaker and disseminated our on-going MRC funded work.
Year(s) Of Engagement Activity 2018
URL https://www.eventbrite.com/e/towards-downsizing-for-portion-control-workshop-at-university-of-leeds-...
 
Description Media appearance discussing research findings 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact We discussed our research findings concerning portion size and obesity (related to MRC grant funded research) as part of filming for a popular mainsteam British TV programme for Channel 4 ('Tricks of the Restaurant Trade'). The piece will be broadcast in early 2019.
Year(s) Of Engagement Activity 2019
 
Description Meet the scientist - dissemination event with young people 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Public/other audiences
Results and Impact We led on a 'meet the scientist' event at Liverpool's World Museum. This involved talking about our ongoing research with children and adolescents. As well as disseminating the importance of healthy eating and portion size, the event was also designed to encourage young people to consider careers in science.
Year(s) Of Engagement Activity 2016
 
Description New Scientist Live Talk 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact I presented work from both our recent MRC and ESRC funded research as an invited speaker at New Scientist Live 2018. New Scientist Live is an international science festival for the general public. The work I presented discussed how obesity can be tackled as a public health issue and what role the general public have in this. The talk was well attended, members of the general public expressed interest in the work, that it had changed the way they think about obesity and requested further information.
Year(s) Of Engagement Activity 2018
URL https://live.newscientist.com/speakers/eric-robinson
 
Description Organisation of portion size conference for academics, public health and industry members 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Industry/Business
Results and Impact We hosted a one day conference on portion size and consumer behaviour. This brought together academic and members of the food industry. Further information can be found here; https://www.liverpool.ac.uk/psychology-health-and-society/events/consumer-behaviour-conference/ . The conference was a success and we are discussing further ways of disseminating our work to interested industry members who attended on the day.
Year(s) Of Engagement Activity 2017
URL https://www.liverpool.ac.uk/psychology-health-and-society/events/consumer-behaviour-conference/
 
Description Pint of Science - Local community public engagement 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Public/other audiences
Results and Impact We delivered a talk and presentation as part of a local science public engagement festival on our MRC and ESRC grant funded research which sparked questions and discussion afterwards.
Year(s) Of Engagement Activity 2018
 
Description Popular media blog 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Third sector organisations
Results and Impact Our team produced an online piece about our on-going MRC funded work and the role that downsizing food portion sizes has in the prevention and treatment of obesity. This online piece was published by Food Active (a public health advocacy organisation).
Year(s) Of Engagement Activity 2017
URL http://www.foodactive.org.uk/guest-blog-downsizing-for-public-health/
 
Description Presentation to Public Health England 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Policymakers/politicians
Results and Impact I was invited to discuss our on-going MRC funded grant work on portion size to Public Health England in order to inform their future policies surrounding nutrition and obesity.
Year(s) Of Engagement Activity 2018
 
Description Press releases for MRC grant funded work 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact In collaboration with our press office we have written and distributed press releases outlining our research findings of relevance to our grant funded work. Examples of these releases and media coverage are outlined below:

https://news.liverpool.ac.uk/2018/04/30/research-supports-reduction-in-food-product-portion-sizes/
https://news.liverpool.ac.uk/2018/12/13/calories-in-popular-restaurant-chain-meals-excessive-warn-experts/

https://www.bbc.co.uk/news/health-46540132
https://www.newfoodmagazine.com/news/66601/research-portion-sizes/
Year(s) Of Engagement Activity 2018
 
Description Series of public engagement visits in local community 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Public/other audiences
Results and Impact Our group hosted a series of interactive events in the local community. These included stalls at a local museum, large local shopping centre and waiting area at a large central train station. Members of the general public took part in interactive displays that taught them about how our on-going research on food, attention and obesity relates to their everyday life (ESRC funded), as well as our research on portion size (MRC funded). A number of attendees reported having learnt new information and this open up an opportunity for dialect and discussion. As a result of the success of these events, our group is now running a workshop for staff members at our University in order to teach others about public dissemination strategies and opportunities.
Year(s) Of Engagement Activity 2017
 
Description The Calorie Reduction Summit 2018 at the Royal Society 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact We presented our MRC grant funded research on how reducing the calorie content of foods can be used to improve public health and tackle obesity as an invited speaker for The Calorie Reduction Summit 2018 at the Royal Society. This summit was attended by politicians, policy makers, the food industry and public health charities. Our work was of importance because it shows that there are unlikely to be negative consequences of reducing calorie content of foods, which is a perceived barrier to change among the food industry.
Year(s) Of Engagement Activity 2018
URL https://www.caloriereductionsummit.com/about-us/