Portion Size

Portion SizeWendy Scinta MD, MS

Everywhere you look, something new is being blamed for America’s obesity crisis. We are eating too much and moving too little. It is due to our stress and our lack of sleep. We are dining in our car, eating on the run, and choosing foods from a box or a fast food restaurant over healthy, homemade meals. Yesterday, fat was to blame, and today it is sugar.  As we search for the truth on how to keep our families healthy, it is impossible to ignore some of the more obvious changes taking place in our food-filled environment- especially as it pertains to portion sizes.

Over the last twenty years, the American diet has changed dramatically both in terms of the quantity and quality of our food intake.  In 1970, Americans took in an average of 2,160 calories per day. Today, it has skyrocketed to 2,673 daily calories per person. As shown in the graph below, we are now eating 20-25 percent more calories than we did in 1970!

average us calorie intake 1970-2009

Source: Dr. Stephan Guyenet. The American Diet. 2012.

How did this happen?  Interestingly, both plate sizes and portion sizes expanded before our eyes.  With the introduction of processed, shelf-ready food in combination with new agriculture policies, food became cheaper and easier to get our hands on than it did in the 1970s.  If you combine this with a society that is always looking to get a bang for their buck, you end up with price wars over who can give you the most food for the least amount of money.  Whether you choose to be “supersized” at McDonalds, or have the “All you can eat pasta” at The Olive Garden, what value-based pricing saves you in cash today may get you tomorrow with the cost of medications and hospital bills.

As the Washington Post showed in the diagram below, many of the meals we are eating out contain as many calories as we need in an entire day.  Thus research has shown, that the more often you eat out or on the road, the more weight you gain.

calorie counts from restaurant meals

Source: Washington Post

If we look at individual foods and compare calories from the 1970s and 1980s to today, it is really telling.  The National Heart, Lung and Blood Institute (NHLBI) has a quiz on their website that every American should take, detailing the tremendous changes in portion sizes over the years (www.nhlbi.nih.gov).  The answers will shock you.

Here is a summary of how some of our favorite foods have changed:

Source: The National Heart, Lung and Blood Institute (NHLBI)

Source: The National Heart, Lung and Blood Institute (NHLBI)

Unfortunately, it is not just the quantity of food we are eating that is a problem, it is also the quality or macronutrients (fat, carbohydrates, and protein).  Unlike lean protein, which tends to help increase muscle mass, the added calories in our diet have been made up of grains, sugars, and unhealthy fats.  Our body can only store so much glucose (the breakdown products of carbohydrates) as energy. The remainder is stored in the liver and fat cells in an unhealthy manner, creating inflammation and contributing to diseases such as high blood pressure, high cholesterol and diabetes.

Given that news, what can we do to help our families stay healthy, or improve our health in this obesogenic environment?  Here are a few tips to help every family survive (and thrive!):

  1. When eating out, ask for a to-go box and take half your meal home.
  2. Try to order protein (meat or fish or plant based such as tofu) over carbohydrates such as pasta, rice and potatoes.
  3. When eating out, ask to hold the starch (pasta, potatoes, rice) and double the veggies.
  4. When serving at home, use smaller plates for the main course, and larger ones for the salad.
  5. When eating at home, try to buy fresh, local produce in season. Stay away from processed foods as much as possible.
  6. When plating your food, make ½ the plate veggies and salad.  The other ½  split into 2/3 protein, and 1/3 carbs.  The starchy carbs should be the smallest item on your plate.
  7. Have your family get up and serve themselves. Don’t leave the food on the table or everyone will eat more.
  8. When lured by more food for less money, look to see if they are just adding more starch (pasta, French fries or rice).  If this is the case, don’t bite!
  9. Limit eating out to no more than once per week, and try to cook more healthy meals at home.
  10. When eating, just eat!  Refrain from watching TV, using electronics, or reading a magazine or book.
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