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      Using multi-theory model to predict initiation and sustenance of small portion size consumption among college students

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          Abstract

          Background: Consumption of large portion sizes is contributing to overweight and obesity.College students are a vulnerable group in this regard. The purpose of this study was to use multi-theory model (MTM) to predict initiation and sustenance of small portion size consumption in college students.

          Methods: A total of 135 students at a large Southern US University completed a 35-item valid (face, content, and construct) and reliable (internally consistent) survey electronically in a cross-sectional design. The main outcome measures were intention to start eating small portion sizes and continuing to eat small portion sizes. Only those students who ate large portion sizes during the past 24 hours were included.

          Results: Step wise multiple regression showed that initiation of small portion size consumption was explained by participatory dialogue (advantages outweighing disadvantages), behavioral confidence, age, and gender (adjusted R 2 = 0.37, P < 0.001). Males were less likely to initiate small portion size consumption than females (β = -0.185, 95% CI = -0.71– -0.11). Regarding sustenance, emotional transformation, changes in social environment, and race were the significant predictors (adjusted R 2 = 0.20, P < 0.001). Whites were less likely to sustain small portion size change than other races (β = -0.269, 95% CI = -0.97 – -0.26).

          Conclusion: Based on this study’s findings, MTM appears to be a robust theoretical framework for predicting small portion size consumption behavior change. Interventions in this regard need to be designed.

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          Most cited references21

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          Effectiveness of interventions targeting physical activity, nutrition and healthy weight for university and college students: a systematic review and meta-analysis

          To examine the effectiveness of interventions aimed at improving physical activity, diet, and/or weight-related behaviors amongst university/college students. Five online databases were searched (January 1970 to April 2014). Experimental study designs were eligible for inclusion. Data extraction was performed by one reviewer using a standardized form developed by the researchers and checked by a second reviewer. Data were described in a narrative synthesis and meta-analyses were conducted when appropriate. Study quality was also established. Forty-one studies were included; of these, 34 reported significant improvements in one of the key outcomes. Of the studies examining physical activity 18/29 yielded significant results, with meta-analysis demonstrating significant increases in moderate physical activity in intervention groups compared to control. Of the studies examining nutrition, 12/24 reported significantly improved outcomes; only 4/12 assessing weight loss outcomes found significant weight reduction. This appears to be the first systematic review of physical activity, diet and weight loss interventions targeting university and college students. Tertiary institutions are appropriate settings for implementing and evaluating lifestyle interventions, however more research is needed to improve such strategies. Electronic supplementary material The online version of this article (doi:10.1186/s12966-015-0203-7) contains supplementary material, which is available to authorized users.
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            Portion size: review and framework for interventions

            The prevalence of overweight and obesity has increased. A strong environmental factor contributing to the obesity epidemic is food portion size. This review of studies into the effects of portion size on energy intake shows that increased food portion sizes lead to increased energy intake levels. Important mechanisms explaining why larger portions are attractive and lead to higher intake levels are value for money and portion distortion. This review also shows that few intervention studies aiming to reverse the negative influence of portion size have been conducted thus far, and the ones that have been conducted show mixed effects. More intervention studies targeted at portion size are urgently needed. Opportunities for further interventions are identified and a framework for portion size interventions is proposed. Opportunities for intervention include those targeted at the individual as well as those targeted at the physical, economic, political and socio-cultural environment.
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              Portion sizes and the obesity epidemic.

              The rise in obesity rates over the past 30 y has been paralleled by increases in the portion size of many foods and the prevalence of eating away from home. Foods of particular concern are those that have a high energy density (kJ/g). Many well-controlled, laboratory-based studies have found that large portions of energy-dense foods can lead to excess energy intakes. This influence of large portions on energy intake has been supported by data collected in naturalistic settings. Further research is needed to explore strategies that can be used to moderate the effects of portion size on food consumption. One promising strategy is to reduce the energy density of foods, while maintaining food weight or volume, so that consumers can eat satisfying portions while reducing their energy intakes. There is a need for effective educational messages that not only emphasize limiting the consumption of foods high in energy density, but also encourage the consumption of those with a low energy density, such as fruits and vegetables. The delivery of consistent messages will require more cooperation among the food and restaurant industries, policy makers, and scientists. Effective strategies will also require consumers to understand and accept the importance of eating reasonable portions for better health.
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                Author and article information

                Journal
                Health Promot Perspect
                Health Promot Perspect
                Health Promot Perspect
                TBZMED
                Health Promotion Perspectives
                Tabriz University of Medical Sciences
                2228-6497
                2016
                10 August 2016
                : 6
                : 3
                : 137-144
                Affiliations
                1Behavioral & Environmental Health, School of Public Health, Jackson State University, MS, USA
                2Public Health Studies, School of Health and Applied Human Sciences, University of North Carolina Wilmington, NC, USA
                3Department of Health, Physical Education, and Exercise Science, School of Allied Health Sciences, Lincoln Memorial University, Harrogate, TN, USA
                4Department of Health, Exercise Science & Recreation Management, School of Applied Sciences, University of Mississippi, MS, USA
                5Department of Management, School of Business Administration, University of Mississippi, MS, USA
                Author notes
                [* ]Corresponding Author: Vinayak K. Nahar, MD, MS; Lincoln Memorial University, Mary Mars, 6965 Cumberland Gap Parkway, Harrogate, TN 37752, USA. Tell: (662) 638-5126; vinayak.nahar@ 123456LMUnet.edu
                Article
                10.15171/hpp.2016.22
                5002880
                27579257
                917cc1fe-d42d-4a3a-b028-0776011e89be
                © 2016 The Author(s).

                This is an open access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 15 June 2016
                : 23 June 2016
                Page count
                Figures: 4, Tables: 4, References: 33
                Categories
                Original Article

                obesity,overweight,portion size,diet,nutrition
                obesity, overweight, portion size, diet, nutrition

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