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

Recent reports have asserted that, because of energy underreporting, dietary self-report data suffer from measurement error so great that findings that rely on them are of no value. This commentary considers the amassed evidence that shows that self-report dietary intake data can successfully be used to inform dietary guidance and public health policy. Topics discussed include what is known and what can be done about the measurement error inherent in data collected by using self-report dietary assessment instruments and the extent and magnitude of underreporting energy compared with other nutrients and food groups. Also discussed is the overall impact of energy underreporting on dietary surveillance and nutritional epidemiology. In conclusion, 7 specific recommendations for collecting, analyzing, and interpreting self-report dietary data are provided: (1) continue to collect self-report dietary intake data because they contain valuable, rich, and critical information about foods and beverages consumed by populations that can be used to inform nutrition policy and assess diet-disease associations; (2) do not use self-reported energy intake as a measure of true energy intake; (3) do use self-reported energy intake for energy adjustment of other self-reported dietary constituents to improve risk estimation in studies of diet-health associations; (4) acknowledge the limitations of self-report dietary data and analyze and interpret them appropriately; (5) design studies and conduct analyses that allow adjustment for measurement error; (6) design new epidemiologic studies to collect dietary data from both short-term (recalls or food records) and long-term (food-frequency questionnaires) instruments on the entire study population to allow for maximizing the strengths of each instrument; and (7) continue to develop, evaluate, and further expand methods of dietary assessment, including dietary biomarkers and methods using new technologies.

Large portions of food may contribute to excess energy intake and greater obesity. However, data on the effects of portion size on food intake in adults are limited. We examined the effect of portion size on intake during a single meal. We also investigated whether the response to portion size depended on which person, the subject or the experimenter, determined the amount of food on the plate. Fifty-one men and women were served lunch 1 d/wk for 4 wk. Lunch included an entrée of macaroni and cheese consumed ad libitum. At each meal, subjects were presented with 1 of 4 portions of the entrée: 500, 625, 750, or 1000 g. One group of subjects received the portion on a plate, and a second group received it in a serving dish and took the amount they desired on their plates. Portion size significantly influenced energy intake at lunch (P < 0.0001). Subjects consumed 30% more energy (676 kJ) when offered the largest portion than when offered the smallest portion. The response to the variations in portion size was not influenced by who determined the amount of food on the plate or by subject characteristics such as sex, body mass index, or scores for dietary restraint or disinhibition. Larger portions led to greater energy intake regardless of serving method and subject characteristics. Portion size is a modifiable determinant of energy intake that should be addressed in connection with the prevention and treatment of obesity.

People seem to think that a unit of some entity (with certain constraints) is the appropriate and optimal amount. We refer to this heuristic as unit bias. We illustrate unit bias by demonstrating large effects of unit segmentation, a form of portion control, on food intake. Thus, people choose, and presumably eat, much greater weights of Tootsie Rolls and pretzels when offered a large as opposed to a small unit size (and given the option of taking as many units as they choose at no monetary cost). Additionally, they consume substantially more M&M's when the candies are offered with a large as opposed to a small spoon (again with no limits as to the number of spoonfuls to be taken). We propose that unit bias explains why small portion sizes are effective in controlling consumption; in some cases, people served small portions would simply eat additional portions if it were not for unit bias. We argue that unit bias is a general feature in human choice and discuss possible origins of this bias, including consumption norms.