Determinants of Portion Size in Children and Adolescents: Insights from the UK National Diet and Nutrition Survey Rolling Programme (2008–2016)
Abstract
:1. Introduction
2. Materials and Methods
2.1. Sample
2.2. Dietary Data
2.3. Other Variables
2.4. Data Analysis
3. Results
3.1. Frequency of Consumption of Target Foods
3.2. Portion Sizes of Target Foods
3.3. Predictors of Portion Sizes (g) of Target Foods
3.4. Energy Consumption Due to Target Foods
3.5. Contribution of Energy Consumption Due to Target Foods to the Overall Diet
4. Discussion
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
- World Health Organization (WHO). Limiting Portion Sizes to Reduce the Risk of Childhood Overweight and Obesity: Biological, Behavioural and Contextual Rationale. 2014. Available online: http://www.who.int/elena/bbc/portion_childhood_obesity/en/ (accessed on 20 May 2019).
- Van der Bend, D.; Bucher, T.; Schumacher, T.; Collins, K.; De Vlieger, N.; Rollo, M.; Burrows, T.; Watson, J.; Collins, C. Trends in Food and Beverage Portion Sizes in Australian Children; a Time-Series Analysis Comparing 2007 and 2011–2012 National Data. Children 2017, 4, 69. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Zheng, M.; Wu, J.H.Y.Y.; Louie, J.C.Y.; Flood, V.M.; Gill, T.; Thomas, B.; Cleanthous, X.; Neal, B.; Rangan, A.; Chun, J.; et al. Typical food portion sizes consumed by Australian adults: Results from the 2011–12 Australian National Nutrition and Physical Activity Survey. Sci. Rep. 2016, 6, 1–9. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Young, L.R.; Nestle, M. Expanding portion sizes in the US marketplace: Implications for nutrition counseling. J. Am. Diet. Assoc. 2003, 103, 231–240. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Marteau, T.M.; Hollands, G.J.; Shemilt, I.; Jebb, S.A. Downsizing: Policy options to reduce portion sizes to help tackle obesity. BMJ 2015, 5863, h5863. [Google Scholar] [CrossRef] [Green Version]
- Ventura, A.K.; Worobey, J. Early influences on the development of food preferences. Curr. Biol. 2013, 23, R401–R408. [Google Scholar] [CrossRef] [Green Version]
- Pourshahidi, L.K.; Kerr, M.A.; McCaffrey, T.A.; Livingstone, M.B.E. Influencing and modifying children’s energy intake: The role of portion size and energy density. Proc. Nutr. Soc. 2014, 73, 397–406. [Google Scholar] [CrossRef] [Green Version]
- Hetherington, M.M.; Blundell-Birtill, P. The portion size effect and overconsumption—Towards downsizing solutions for children and adolescents. Nutr. Bull. 2018, 43, 61–68. [Google Scholar] [CrossRef] [Green Version]
- Zuraikat, F.M.; Smethers, A.D.; Rolls, B.J. Potential moderators of the portion size effect. Physiol. Behav. 2019, 204, 191–198. [Google Scholar] [CrossRef]
- Kling, S.M.R.; Roe, L.S.; Keller, K.L.; Rolls, B.J. Double trouble: Portion size and energy density combine to increase preschool children’s lunch intake. Physiol. Behav. 2015, 162, 18–26. [Google Scholar] [CrossRef] [Green Version]
- Lioret, S.; Volatier, J.L.; Lafay, L.; Touvier, M.; Maire, B. Is food portion size a risk factor of childhood overweight? Eur. J. Clin. Nutr. 2009, 63, 382–391. [Google Scholar] [CrossRef]
- Johnson, S.L.; Hughes, S.O.; Cui, X.; Li, X.; Allison, D.B.; Liu, Y.; Goodell, L.S.; Nicklas, T.; Power, T.G.; Vollrath, K. Portion sizes for children are predicted by parental characteristics and the amounts parents serve themselves. Am. J. Clin. Nutr. 2014, 99, 763–770. [Google Scholar] [CrossRef] [PubMed]
- Potter, C.; Ferriday, D.; Griggs, R.L.; Hamilton-Shield, J.P.; Rogers, P.J.; Brunstrom, J.M. Parental beliefs about portion size, not children’s own beliefs, predict child BMI. Pediatr. Obes. 2018, 13, 232–238. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Kairey, L.; Matvienko-Sikar, K.; Kelly, C.; McKinley, M.C.; O’Connor, E.M.; Kearney, P.M.; Woodside, J.V.; Harrington, J.M. Plating up appropriate portion sizes for children: A systematic review of parental food and beverage portioning practices. Obes. Rev. 2018, 19, 1667–1678. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Croker, H.; Sweetman, C.; Cooke, L. Mothers’ views on portion sizes for children. J. Hum. Nutr. Diet. 2009, 22, 437–443. [Google Scholar] [CrossRef] [PubMed]
- Albar, S.A.; Alwan, N.A.; Evans, C.E.L.L.; Cade, J.E. Is there an association between food portion size and BMI among British adolescents? Br. J. Nutr. 2014, 112, 841–851. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Hetherington, M.M.; Blundell-Birtill, P.; Caton, S.J.; Cecil, J.E.; Evans, C.E.; Rolls, B.J.; Tang, T. Understanding the science of portion control and the art of downsizing. Proc. Nutr. Soc. 2018, 77, 347–355. [Google Scholar] [CrossRef] [Green Version]
- Public Health England Change 4 Life 100 calorie snacks. Available online: https://www.nhs.uk/change4life/food-facts/healthier-snacks-for-kids/100-calorie-snacks (accessed on 30 November 2018).
- Torun, B. Energy requirements of children and adolescents. Public Health Nutr. 2005, 8, 968–993. [Google Scholar] [CrossRef] [Green Version]
- Ziauddeen, N.; Almiron-Roig, E.; Penney, T.L.; Nicholson, S.; Kirk, S.F.L.; Page, P. Eating at food outlets and “on the go” is associated with less healthy food choices in adults: Cross-sectional data from the uk national diet and nutrition survey rolling programme (2008–2014). Nutrients 2017, 9, 1315. [Google Scholar] [CrossRef] [Green Version]
- Hetherington, M.M.; Anderson, A.S.; Norton, G.N.M.; Newson, L. Situational effects on meal intake: A comparison of eating alone and eating with others. Physiol. Behav. 2006, 88, 498–505. [Google Scholar] [CrossRef]
- Houle-Johnson, S.A.; Kakinami, L. Do sex differences in reported weight loss intentions and behaviours persist across demographic characteristics and weight status in youth? A systematic review. BMC Public Health 2018, 18, 1–17. [Google Scholar] [CrossRef]
- Ramos, P.; Moreno-Maldonado, C.; Moreno, C.; Rivera, F. The Role of Body Image in Internalizing Mental Health Problems in Spanish Adolescents: An Analysis According to Sex, Age, and Socioeconomic Status. Front. Psychol. 2019, 10, 1952. [Google Scholar] [CrossRef] [PubMed]
- Toumpakari, Z.; Haase, A.M.; Johnson, L. Adolescents’ non-core food intake: A description of what, where and with whom adolescents consume non-core foods. Public Health Nutr. 2016, 19, 1645–1653. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- MRC Elsie Widdowson Laboratory. NatCen Social Research. In National Diet and Nutrition Survey Years 1–8, 12th ed.; SN: 6533; UK Data Service: Colchester, UK, 2018. [Google Scholar] [CrossRef]
- Fitt, E.; Cole, D.; Ziauddeen, N.; Pell, D.; Stickley, E.; Harvey, A.; Stephen, A.M. DINO (Diet in Nutrients Out)—An integrated dietary assessment system. Public Health Nutr. 2015, 18, 234–241. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Wrieden, W.L.; Longbottom, P.J.; Adamson, A.J.; Ogston, S.A.; Payne, A.; Haleem, M.A.; Barton, K.L. Estimation of typical food portion sizes for children of different ages in Great Britain. Br. J. Nutr. 2008, 99, 1344–1353. [Google Scholar] [CrossRef] [Green Version]
- Eck, K.M.; Delaney, C.L.; Leary, M.P.; Famodou, O.A.; Olfert, M.D.; Shelnutt, K.P.; Byrd-Bredbenner, C. “My tummy tells me” cognitions, barriers and supports of parents and school-age children for appropriate portion sizes. Nutrients 2018, 10, 1040. [Google Scholar] [CrossRef] [Green Version]
- Blake, C.E.; Fisher, J.O.; Ganter, C.; Younginer, N.; Orloski, A.; Blaine, R.E.; Bruton, Y.; Davison, K.K. A qualitative study of parents’ perceptions and use of portion size strategies for preschool children’s snacks. Appetite 2015, 88, 17–23. [Google Scholar] [CrossRef] [Green Version]
- Reale, S.; Hamilton, J.; Akparibo, R.; Hetherington, M.M.; Cecil, J.E.; Caton, S.J. The effect of food type on the portion size effect in children aged 2–12 years: A systematic review and meta-analysis. Appetite 2019, 137, 47–61. [Google Scholar] [CrossRef]
- Vandenbroele, J.; Van Kerckhove, A.; Zlatevska, N. Portion size effects vary: The size of food units is a bigger problem than the number. Appetite 2019, 140, 27–40. [Google Scholar] [CrossRef]
- Keller, K.L.; Kling, S.M.R.; Fuchs, B.; Pearce, A.L.; Reigh, N.A.; Masterson, T.; Hickok, K. A biopsychosocial model of sex differences in children’s eating behaviors. Nutrients 2019, 11, 682. [Google Scholar] [CrossRef] [Green Version]
- Rangan, A.M.; Schindeler, S.; Hector, D.J.; Gill, T.P. Assessment of typical food portion sizes consumed among Australian adults. Nutr. Diet. 2009, 66, 227–233. [Google Scholar] [CrossRef]
- Cohen, D.A.; Lesser, L.I.; Wright, C.; Story, M.; Economos, C.D. Kid’s Menu Portion Sizes. Nutr. Today 2016, 51, 273–280. [Google Scholar] [CrossRef]
- Goffe, L.; Rushton, S.; White, M.; Adamson, A.; Adams, J. Relationship between mean daily energy intake and frequency of consumption of out-of-home meals in the UK National Diet and Nutrition Survey. Int. J. Behav. Nutr. Phys. Act. 2017, 14, 1–11. [Google Scholar] [CrossRef] [PubMed]
- Kerr, M.A.; Rennie, K.L.; Mccaffrey, T.A.; Wallace, J.M.W.; Hannon-Fletcher, M.P.; Livingstone, M.B.E. Snacking patterns among adolescents: A comparison of type, frequency and portion size between Britain in 1997 and Northern Ireland in 2005. Br. J. Nutr. 2009, 101, 122–131. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Rennie, K.L.; Jebb, S.A.; Wright, A.; Coward, W.A. Secular trends in under-reporting in young people. Br. J. Nutr. 2005, 93, 241–247. [Google Scholar] [CrossRef] [Green Version]
- Lennox, A.; Bluck, L.; Page, P.; Pell, D.; Cole, D.; Ziauddeen, N.; Steer, T.; Nicholson, S.; Goldberg, G.; Prentice, A. Misreporting in the National Diet and Nutrition Survey Rolling Programme (NDNS RP): Summary of results and their interpretation, PHE, London. 2014. Available online: https://www.food.gov.uk/sites/default/files/media/document/ndns-appendix-x.pdf (accessed on 10 May 2019).
- Deming, D.M.; Reidy, K.C.; Fox, M.K.; Briefel, R.R.; Jacquier, E.; Eldridge, A.L. Cross-sectional analysis of eating patterns and snacking in the US Feeding Infants and Toddlers Study 2008. Public Health Nutr. 2017, 20, 1584–1592. [Google Scholar] [CrossRef] [Green Version]
- Drewnowski, A.; Specter, S. Poverty and obesity: The role of energy density and energy costs. Am. J. Clin. Nutr. 2004, 79, 6–16. [Google Scholar] [CrossRef]
- Drewnowski, A. Obesity, diets, and social inequalities. Nutr. Rev. 2009, 67, S36–S39. [Google Scholar] [CrossRef]
- Kirwan, L.; Walsh, M.C.; Brennan, L.; Gibney, E.R.; Drevon, C.A.; Daniel, H.; Lovegrove, J.A.; Manios, Y.; Martínez, J.A.; Saris, W.H.M.; et al. Comparison of the portion size and frequency of consumption of 156 foods across seven European countries: Insights from the Food4ME study. Eur. J. Clin. Nutr. 2016, 70, 642–644. [Google Scholar] [CrossRef]
- Reid, M.; Hammersley, R. Is the British diet improving? Nutr. Bull. 2016, 41, 360–364. [Google Scholar] [CrossRef]
- Llauradó, E.; Albar, S.A.; Giralt, M.; Solà, R.; Evans, C.E.L. The effect of snacking and eating frequency on dietary quality in British adolescents. Eur. J. Nutr. 2016, 55, 1789–1797. [Google Scholar] [CrossRef] [Green Version]
- Herman, C.P.; Polivy, J.; Vartanian, L.R.; Pliner, P. Are large portions responsible for the obesity epidemic? Physiol. Behav. 2016, 156, 177–181. [Google Scholar] [CrossRef] [PubMed]
Where | Biscuits | Chocolate | Confectionery | Crisps & Savoury Snacks | ||||
---|---|---|---|---|---|---|---|---|
Home | 6831 | 54.8% | 4114 | 56.7% | 2114 | 48.8% | 4553 | 49.1% |
School (incl. work) | 3151 | 25.3% | 1026 | 14.1% | 495 | 11.4% | 2360 | 24.4% |
Other | 1170 | 9.4% | 743 | 10.2% | 467 | 10.8% | 900 | 9.7% |
On the go | 802 | 6.4% | 909 | 12.5% | 815 | 18.8% | 986 | 10.6% |
Leisure | 308 | 2.5% | 299 | 4.1% | 318 | 7.3% | 325 | 3.5% |
Food Outlet | 193 | 1.5% | 163 | 2.2% | 127 | 2.9% | 155 | 1.7% |
Watching TV | ||||||||
No | 6747 | 54.2% | 3765 | 51.9% | 2408 | 55.5% | 4940 | 53.2% |
Not specified | 1793 | 14.4% | 1002 | 13.8% | 702 | 16.2% | 1364 | 14.7% |
Yes | 3915 | 31.4% | 2487 | 34.3% | 1226 | 28.3% | 2975 | 32.1% |
Time of day | ||||||||
06:00 to 08.59 | 704 | 5.7% | 239 | 3.3% | 90 | 2.1% | 81 | 0.9% |
09:00 to 11.59 | 2486 | 20.0% | 971 | 13.4% | 612 | 14.1% | 1547 | 16.7% |
12:00 to 13.59 | 2949 | 23.7% | 1382 | 19.1% | 748 | 17.3% | 3191 | 34.4% |
14:00 to 16.59 | 3143 | 25.2% | 2126 | 29.3% | 1460 | 33.7% | 2262 | 24.4% |
17:00 to 19.59 | 1832 | 14.7% | 1523 | 21.0% | 917 | 21.1% | 1195 | 12.9% |
20:00 to 21.59 | 1086 | 8.7% | 843 | 11.6% | 422 | 9.7% | 794 | 8.6% |
22:00 to 05.59 | 255 | 2.0% | 170 | 2.3% | 87 | 2.0% | 209 | 2.3% |
Factor/Predictor | Biscuits | Chocolates | Confectionery | Crisps and Savoury Snacks |
---|---|---|---|---|
Intercept | 0.72 | 0.67 | 0.58 | 0.55 |
Age | 0 | 0 | 0.001 | 0.001 |
Sex (reference category male) | 0.002 | 0.002 | 0.013 | 0 |
Meal location (reference category home) | ||||
Leisure | −0.7 | −0.6 | −0.5 | −0.5 |
Food outlet | −0.7 | −0.6 | −0.6 | −0.5 |
On the go | −0.6 | −0.5 | −0.4 | −0.4 |
School | −0.4 | −0.5 | −0.4 | −0.3 |
Other | −0.6 | −0.6 | −0.5 | −0.4 |
Biscuits | Chocolate | Confectionery | Crisps and Savoury Snacks | |||||
---|---|---|---|---|---|---|---|---|
Factor/Predictor | F-Test | Parameter | F-Test | Parameter | F-Test | Parameter | F-Test | Parameter |
Intercept | 27.8 *** | 26.9 *** | 28.9 *** | 26.1 *** | ||||
Age | F(1, 6876) = 290.3 *** | 1.17 *** | F(1, 3131.1) = 433.1 *** | 2.3 *** | F(1, 3177) = 68.3 *** | 2.2 *** | F(1, 9164.8) = 148.2 *** | 1.5 *** |
Sex (reference category male) | F(1, 6706) = 5.7 * | 1.5 | F(1, 4662.4) = 35.6 *** | −8.9 ** | F(1, 2076) = 26.1 *** | −8.5 *** | F(1, 7430.5) = 24.5 *** | −1.9 ** |
Meal location (reference category home) | F(5, 12.80) = 4.2 *** | F(5, 7239.3) = 10.4 *** | F(5, 4195) = 35.0 *** | F(5, 9004.5) = 16.1 *** | ||||
Leisure | 2.7 * | 7.7 *** | 28.4 *** | 11.4 *** | ||||
Food outlet | 0.9 | −1.9 | 4.8 | 3.3 | ||||
On the go | 1.2 | 4.7 *** | 1.1 | 3.1 *** | ||||
School | −1.2 * | −1.6 | −6.7 ** | 0.2 | ||||
Other | 1.4 * | 0.7 | −2.6 | 0.8 | ||||
Time of meal (reference category 06:00 to 08:59) | F(6, 11740) = 2.9 ** | F(6, 7093.5) = 5.5 *** | F(6, 3947) = 5.1 *** | F(6, 8656.6) = 4.7*** | ||||
09:00 to 11:59 | 2.3 | 7.0 ** | −8.5 | −1.6 | ||||
12:00 to 13:59 | 3.7 ** | 2.6 | 12.1 ** | −1.6 | ||||
14:00 to 16:59 | 2.1 | 5.9 * | 12.7 *** | −1.0 | ||||
17:00 to 19:59 | 3.0 * | 5.5 * | 16.4 *** | 0.4 | ||||
20:00 to 21:59 | 1.4 | 8.8 *** | 14.7 *** | 1.9 | ||||
22:00 to 05:59 | 2.2 | 6.4 | 14.6 ** | −4.0 | ||||
Watching TV | F(1, 12077) = 22.5 *** | 2.2 *** | F(1, 7219.6) = 5.3 * | 1.7 * | F(1, 8909.5) = 19.7 *** | 2.0 *** | ||
Income | F(1, 4097) = 11.7 *** | −1.0 *** | F(1, 2674.3) = 22.5 *** | −1.9 *** | F(1, 3849.7) = 5.6 * | −0.6 | ||
Age x Sex | F(1, 3043.2) = 41.2 *** | −1.1 *** | F(1, 2133) = 16.8 *** | −1.5 *** | F(1, 7388.1) = 8.3 ** | −0.2 * | ||
Age x Meal location | F(5, 12235) = 3.5 ** | F(5, 4281) = 7.3 *** | F(5, 9142.3) = 15.0 *** | |||||
Age—Leisure | 0.4 | 3.2 *** | 2.7 *** | |||||
Age—Food outlet | 0.9 ** | −0.5 | −1.1 ** | |||||
Age—On the go | 0.3 | 0.1 | 0.6 *** | |||||
Age—School | 0 | 0.2 | −0.1 | |||||
Age—Other | 0.3 * | −0.2 | 0.2 | |||||
Age x Time of meal | F(6, 8747.9) = 3.0 ** | |||||||
Age—09:00 to 11:59 | −0.7 | |||||||
Age—12:00 to 13:59 | −0.6 | |||||||
Age—14:00 to 16:59 | −0.6 | |||||||
Age—17:00 to 19:59 | −0.2 | |||||||
Age—20:00 to 21:59 | −0.7 | |||||||
Age—22:00 to 05:59 | 0.1 | |||||||
Sex x Meal location | F(5, 9021.3) = 3.2 ** | |||||||
Female—Leisure | −7.5 *** | |||||||
Female—Food outlet | −2.3 | |||||||
Female—On the go | 0.4 | |||||||
Female—School | −0.3 | |||||||
Female—Other | −0.5 | |||||||
Sex x time of meal | F(6, 11745) = 2.5 * | F(6, 7104.5) = 3.0 ** | ||||||
Sex—09:00 to 11:59 | −3.8 * | 1.9 | ||||||
Sex—12:00 to 13:59 | −4.5 ** | 8.0 * | ||||||
Sex—14:00 to 16:59 | −4.6 ** | 4.2 | ||||||
Sex—17:00 to 19:59 | −5.6 ** | 5.5 | ||||||
Sex—20:00 to 21:59 | −4.8 * | 0.9 | ||||||
Sex—22:00 to 05:59 | 0.9 | −1.6 | ||||||
Age x BMI category | F(2, 4463) = 7.6 *** | |||||||
Age—Overweight | 1.0 *** | |||||||
Age—Obesity | 0.2 | |||||||
Age x Sex x Meal location | F(5, 9132.3) = 6.6 *** | |||||||
Female—Age—Leisure | −2.1 *** | |||||||
Female—Age—Food outlet | 1.1 * | |||||||
Female—Age—On the go | −0.3 | |||||||
Female—Age—School | 0.1 | |||||||
Female—Age—Other | 0.1 | |||||||
Age x Sex x BMI category | F(2, 4453) = 3.8 * | |||||||
Age—Sex—Overweight | −0.9 * | |||||||
Age—Sex—Obesity | −0.5 |
Factor/Predictor | Biscuit | Chocolate | Confectionery | Crisps and Savoury Snacks |
---|---|---|---|---|
Intercept | 95 | 103.5 | 61.6 | 74.5 |
Age | 1.3 | 1.7 | 1.1 | 1 |
Sex (reference category male) | −2.4 | −3.7 | −4.3 | −2.1 |
Meal location (reference category home) | ||||
Leisure | −89.6 | −93.6 | −40.2 | −68.0 |
Food outlet | −90.8 | −98.8 | −56.1 | −71.7 |
On the go | −82.9 | −77.2 | −34.5 | −57.5 |
School | −51.8 | −74.4 | −47.3 | −38.7 |
Other | −78.3 | −83.1 | −47.0 | −60.2 |
Factor/Predictor | F-Test | Parameter |
---|---|---|
Intercept | 15.64 *** | |
Age | F(1, 5805) = 94.7 *** | 0.16 *** |
Sex (reference category male) | F(1, 5510) = 5.4 * | 0.52 * |
Age x Sex | F(1, 5805) = 7.5 ** | 0.12 ** |
Income | F(1, 5416) = 30.7 *** | −0.84 *** |
Income x Sex | F(1, 5416) = 4.1 * | 0.45 * |
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Blundell-Birtill, P.; Hetherington, M.M. Determinants of Portion Size in Children and Adolescents: Insights from the UK National Diet and Nutrition Survey Rolling Programme (2008–2016). Nutrients 2019, 11, 2957. https://doi.org/10.3390/nu11122957
Blundell-Birtill P, Hetherington MM. Determinants of Portion Size in Children and Adolescents: Insights from the UK National Diet and Nutrition Survey Rolling Programme (2008–2016). Nutrients. 2019; 11(12):2957. https://doi.org/10.3390/nu11122957
Chicago/Turabian StyleBlundell-Birtill, Pam, and Marion M. Hetherington. 2019. "Determinants of Portion Size in Children and Adolescents: Insights from the UK National Diet and Nutrition Survey Rolling Programme (2008–2016)" Nutrients 11, no. 12: 2957. https://doi.org/10.3390/nu11122957