Barriers to the practice of appropriate portion size control
Seven key interacting barriers to appropriate portion size control were identified: (1) lack of clarity and irrelevance of suggested serving size guidance; (2) guiltless eating; (3) lack of self-control over food cues; (4) distracted eating; (5) social pressures; (6) emotional eating rewards; and (7) quantification habits ingrained from childhood.
(1) Lack of clarity and irrelevance of suggested serving size guidance
During the discussion, it became evident that consumers felt they were repeatedly exposed to numerous conflicting, inconsistent (e.g. “they’re always changing their minds”) and confusing messages in relation to ‘what’ and ‘how much’ they should eat. Across all groups, consumers recalled different suggested serving sizes for particular foods and food groups, gleaned from the public, private, and voluntary sectors (e.g. dietitians, slimming groups, food packets). More often than not, this mix of advice contributed to its reduced effectiveness:
Group nine participant: “…you’re permeated with this stuff [healthy eating guidance]…you’re so bogged down with it, it’s actually information overload and it just gets to the point where it’s not effective anymore.”
Responses also highlighted the difficulty of obtaining serving guidance in meaningful amounts which could be easily remembered. Specifically, the majority of participants acknowledged that household measurements were open to interpretation (e.g. “a glass could be a shot glass or pint glass”), and, they poorly recognised the actual quantity of servings specified in imperial (e.g. 2oz cheese) and metric measurements (e.g. 56g cheese):
Group nine participant: “But to me, it’s like talking about a trillion pounds; I actually have no idea what that is.”
Although participants agreed that serving size guidance should be publicly disseminated, this advice was viewed as irrelevant by those who didn’t have a medical condition (i.e. obesity, diabetes, renal disease):
Group seven participant: “Let’s just say if you had high cholesterol you would want more information on the food and stuff but I think that at our age, I don’t think it’s really that valid for us.”
Group nine participant: “If you were on a diet you would pay attention to food portion size, and, if you’re not, you just eat whatever you want.”
Indeed, participants were unanimous in agreeing that some dietary serving size suggestions were “too small” (e.g. cereal) and frequently questioned the generalisability of such advice to an entire population with a compilation of varying energy requirements (attributed to age, sex, metabolic rates, and physical activity), sporting needs (e.g. extra protein for building/maintaining muscle mass), and, feeding styles (e.g. meal frequency and structure):
Group seven participant: “30g of cereal…that’s like, for a guinea pig! But who is a serving for? You don’t know if it’s for a small, petite lady or is it for us lads who play rugby? That can be wrong so how do you judge by that.”
Group four participant: “Because I’m eating small I eat more often, probably having five meals.”
(2) Guiltless eating
Discussion within this theme concentrated largely on perceptions about the healthiness of food (i.e. “if it’s healthy, I can eat more”) and the prevalent belief that you could eat ‘extra’ after exercise (despite consciously acknowledging that energy consumption may well outweigh energy expenditure). Foremost, it was evident that participants’ beliefs about healthy eating were a major factor in determining ideal portion size, with ‘healthy’ foods being exempt from the practice of portion control. For example, foods such as: chicken, potatoes, cereal, fruits, vegetables, salad, eggs, and pasta, were deemed ‘healthy’ and their portion size control was seen as unnecessary. Conversely, chocolate, cake, biscuits, crisps, ice-cream, cola, sweets, cakes, chips, coleslaw, and processed/take-away food, were classified as ‘unhealthy’ and thus eligible for restriction. For example, one participant stated:
Group seven participant: “I don’t think portion sizes really matter for the likes of chicken and potatoes and all, but it does for chocolate or a cake, like there’s a cake in my fridge…you’re not going to eat the whole thing. Although some people might, I wouldn’t. For healthy food, you’ll just eat away and away at it cos you know it’s fine…like if I’m making scrambled egg, I’ll just throw 5–6 eggs in it”.
Various factors influenced the healthy/unhealthy categorisation of foods, such as their perceived: nutritional content and the addition of additives; level of processing; country of origin; and some beliefs related to their advertising (e.g. “that impression that you’ll fit into the wee red dress”).When the moderator enquired specifically about the influence of low-fat nutrition claims on consumption, there was an agreement that low-fat invariably meant “low-taste”, with most participants stating that they would rather avoid low-fat foods, and “just eat less” of the its full-fat counterpart. It was widely acknowledged that low-fat food was not necessarily low in energy due to its typical see-saw relationship with sugar, as illustrated below:
Moderator: “And if something was labelled as low-fat, does that influence how much you eat?
Group ten participant: No, because its low-fat doesn’t mean there’s no sugar in it.
Moderator: How about low-sugar labelling?
Group ten participant: No, cos then again it could be high in fat. Again it’s turning the packet over and reading, cos just because something says its low-fat, they still have to have flavour in it. So they’ve taken the fat out and put the sugar in it.”.
(3) Lack of self-control over food cues
There was agreement among many participants that the mere presence of large quantities/servings of food, would simply prompt overconsumption as it gave one the liberty to consume more:
Group seven participant: “Like today I went and got five boxes of Rice Krispies because it was on offer. I’ll eat more. The same goes for your car, if the petrol’s like up here, you go driving all over!”
Specifically, larger pack sizes (e.g. kingsize and share packs) generally increased consumption, as it was particularly difficult for participants to “close up the pack” and “resist temptation”. Additionally, single householders felt that a wide range of product packs were often designed for two people, and, in a similar way, also prompted them to overeat:
Group four participant: “I live on my own so like there are a lot of things that you’d buy are designed for two people. Do you know what I mean? And then, you’d end up eating three-quarters of it or, probably eat the whole pack. Rice for example. They don’t cater for one person.”
Despite several participants reporting that multi-pack servings would provide a discrete stopping point and form a “psychological” barrier to further consumption, others viewed multi-pack servings as “just too tiny” and as a result consumed an additional pack to compensate for the reduction in pack size.
(4) Distracted eating
Participants recognised that many elements of the eating environment often diverted their attention away from their dietary intake and subsequently resulted in a lack of portion size control. Specifically, participants reported that it was possible for them to show no meal-to-meal compensation for increased energy intakes when larger portions were consumed:
Group four participant: “But if it’s something you’re doing automatically, then you’ll have your big breakfast, your large lunch, your large dinner and later on you might even order Chinese food.”
Furthermore, socialising with friends and family (e.g. at parties, restaurants) reportedly obscured the participants’ ability and motivation to monitor food consumption in addition to distractions within the work and home environment (such as televisions, computers and phones), for example:
Group one participant: “I think too it depends on what you are doing, if you’re sitting at the table and you’re eating, I think you’re more inclined to say that I’m full. Whereas if I’m sitting in the living room, and I’ve a bad habit of that, watching TV and eating, I look down and my plates empty.”
Group one participant: “I think as well, if you’re having a night in, like a DVD with friends and bowls of popcorn and sweets, no-one’s thinking about portion sizes. It’s kind of your spoiling yourself you know.”
(5) Social pressures
Despite reportedly self-restricting portion size in the company of certain people (e.g. friends), most participants admitted that they also regularly consumed larger portion sizes in order to impress or ingratiate themselves to hosts/fellow diners. Overall, participants collectively agreed that there was a uniform requirement to be a “good guest” when visiting someone’s home. This often involved consuming unappealing food (principally due to taste) to beyond the point of fullness; in order to be polite and not offend the host. One participant stated:
Group seven participant: “If you’re at somebody’s house and even if it’s a terrible feed like, you’re not going to leave it all, you’re going to eat a certain amount, so they don’t get offended, you know.”
In some instances, males in particular viewed eating as a “test of manhood”, and, described these instances where they were teased by their male peers because of their reluctance to consume more:
Group four participant: “Let’s say I was out on a Saturday or whatever, with a girl, you’re not going to sit and pig your face out, the way you do at home. You’re going to be half reserved. It’s completely barbaric when its men only, you just go mad. Same as drink, you’re trying to out-drink each other.”
Group seven participant: “Or when you’re there like, eating Chinese food and then you don’t feel like anymore. And then there’s a man aspect comes in…someone’s like, ‘finish that you fairy’!”
Females also reported increasing their habitual portion sizes in the company of male diners to avoid appearing “mean about food” or feeling “like a spoil sport”. For instance, one participant reported that she didn’t want to give the impression that she was “constantly counting calories”.
(6) Emotional eating rewards
Within this theme, participants described psychological factors inherent within themselves which impacted on their food portion size consumption. Participants reported an association between emotions and the consumption of larger portions of certain “comfort” foods, such as ice-cream, chocolate, and crisps. These “comfort” foods reportedly provided a positive elevation in mood when participants were feeling upset, rejected, worried, stressed, bored or depressed:
Group six participant: “Well if I’m bored, or if I’m having a really bad day, I’m like right give me the chips and dip- I’m eating the whole bag! So whereas if I was in a good mood and I thought I was being good and active on that day, I wouldn’t eat as much because I wouldn’t be sitting there thinking “Right, I need to cheer myself up.”
(7) Quantification habits ingrained from childhood
All participants’ stated that their portion sizes were determined by “habit”, with food items repeatedly being prepared, served, and consumed in the same quantities. Frequently, participant’s spontaneously acknowledged that their portion sizes were guided by their mothers’ practices when they were growing up, which, in turn, were often influenced by traditional culture and customs:
Group eight participant: “But I think that’s [portion sizes] set by even your upbringing, because my husband doesn’t eat so much because he was never given large portions but I would eat more because we were obviously given bigger portions when we were young.”
Group six participant: “But I think it’s an Irish thing too. In Ireland we always feed people with potatoes, we eat way too much carbohydrate. You see people putting potato on top of rice!!”
In addition to embedding portion norms, parents often instilled participants with core values in relation to food waste during their childhood; with the result that many felt obligated to finish all the food on their plate. This was particularly true for the more expensive foodstuffs, such as meat. Many recalled instances whereby their parents used tactics, such as, guilt (“there are people starving in Africa”), bribery (“you won’t get dessert”) or a battle of wills (“you can’t leave the table”) to encourage them to finish all the food on their plates from an early age. In some cases, participants perceived that they were encouraged to eat large portions sizes, not only on account of reducing food waste, but also because they appeared poorly nourished to their mother:
Group six participant: “Probably the reason why I would actually eat more than any other normal person should eat, was, when I was actually younger, even as a child, and my mother used to say I was very, very poorly looking. So, I was the one who was given the plate with everything bunged unto it and I was told ‘there’s people in Africa starving, don’t waste food’. You see, that’s where it stems from, and I would still do that yet.”
Even for participants who “retrained their own mind” to recognise appropriate portion sizes and utilize effective portion size control strategies to prevent overeating, the concept of ‘cleaning the plate’ was still a constant challenge to overcome. For example:
Group one participant: “… Like now I don’t overeat but if there was a big plate or something in front of me like I definitely would eat it all because I have that thing like I can’t waste this.”