Portions served in restaurants seems innocuous enough to avoid any scrutiny. It appears however that the portions do contribute to health issues such as obesity given the current trend of more and more families eating in restaurants. There is a need to investigate the patterns and trends of modern commensality as well as the portions and types of food served in the restaurants to gain a holistic view of the effect of the size of portion being served. The trend of commensality shows that food consumed outside of the home increased from 34% of the food budget in 1970 (1) to 47% (2) by the late 1990s. With regards to the portion sizes, between 1977 and 1996, portion sizes increased for all key food at all locations examined for the total US population (3). With the statistics given, the effects of the food portions served in restaurants will be evaluated.

The prevalence of overweight and obesity has increased sharply among US adults and children in recent years (4). Although multiple factors can account for weight gain, the evidence of excess food intake being the cause lies in the fact that activity patterns have not changed much in the past decade (5). Overweight and obesity are major health concerns as they raise risks for a variety of medical conditions including type 2 diabetes, hyperlipidemia, hypertension, coronary heart disease and certain cancers (6), as well as for premature death (7). If current trends continue, 43% of U.S. adults will be obese and obesity spending will quadruple to $344 billion by 2018, according to a new study. On the other hand, if
obesity rates hold steady, the U.S. would save nearly $200 billion in healthcare costs – or about $820 per adult (8). As can be observed from the results, reducing obesity is a social as well as an economical necessity. One essential factor to be taken into account will hence be the the investigation of the sizes of portions now served in restaurants. The study needs to identify the types of restaurants that are most pervasive in serving larger portions of food. For most of the selected food being studied, fast food establishments served the largest and restaurants served the smallest portion sizes. Therefore our focus needs to be on fast food restaurants especially since they serve the most unhealthy food as well. Studies showed that the portions fast food restaurants served for hamburger increased 500%, soda increased 457% and french fries increased 250% in 2006 as compared to 1955. Notwithstanding the trends, the advertisements and the naming of their food products have the misleading effect to the consumers that they are not eating any extra portions. For instance, Mcdonald’s renaming of its French fries in 1998. They used to come in Small(2.4oz), Large (5.3oz) and Supersize(6.3oz). In 2002, Supersize was increased to 7.1oz and the other three sizes renamed as Small, Medium and Large (9). Consumers are hence taking in larger portions without them actually realizing it. Given the current fashion trends of being thin and slim, obesity is frown upon. However a recent survey shows that Americans tend to ignore serving size when they are attempting to maintain body weight (10). Hence, the portions served in restaurants can be of paramount importance to the health of a nation due to the unhealthy food being served, the misleading packaging and also the ignorance of portion sizes being served.

A case study of France’s restaurants’ serving portions versus that of the United States and their incidence of obesity helps reinforce the importance of the size of portions served by restaurants. There is much evidence that obesity is induced by an environment that promotes eating of large amounts of highly palatable food (11). The portion size in France is generally smaller than the United States and the French eat less but take longer time to eat than the Americans (12). The consequences of the smaller portions and longer eating time may be the cause of the striking differences between the mean body mass index of French versus Americans. For the average French adults it is 24.4 while for the Americans it is 26.6. (National Center for Health Statistics, 2002, data for 1988-1994). The BMI figures are reinforced by the health statistics. The mortality rate from heart disease is substantially lower among the French than the Americans (13) although both are affluent countries with a fashion concern and fad for slim and thin appearances.

The size of portions served in restaurants are of significance especially in fast food establishments. This is due to the fact that the trends are towards eating outside and fast food restaurants are affordable and pervasive everywhere. This coupled with the increasing size of the portions served as well as the deliberate attempts of the restaurants to mask the true increase in the portions resulted in obesity which is of huge social and economical costs. The case study of the French versus the Americans on the issue of the portions of food served further reinforced the importance of the size of the food portion served especially given the fact that humans do not perceive the food portions served even when they are on a lookout for their weights. An interesting observation is that even though the food portion served in France is smaller than in the United States, the French took longer in their meals. Commensality behavior can have an effect on the health issues too. Given smaller portions, the diner may not be facing the same time pressure as another diner who is faced with a larger portion and can enjoy his food better and hence take longer to ingest his food which will be good for digestion. Therefore the psychology of commensality may be worth studying as to the effect of the food portions and not just concentrating on the size of the portions per se.

References
1 US Trends in Eating Away From Home, 1982-1989. Washington, DC: US Department of Agriculture, Economic Research Service; 1995. Statistical Bulletin 926.
2 Clauson A. Share of food spending for eating out reaches 47 percent. 1999;22:20-22.
3 Nielsen S.J., Popkin B.M. Patterns and Trends in Food Portion Sizes, 1977-1998. JAMA.
4 Mortality Statistics Branch, National Center for Health Statistics. Update Prevalence of Overweight among children, adolescents and adults – United States. 1988-1994. MMWR Morb Mortal Wrkly Rep. 1997:46:199-202
5 Mortality Statistics Branch, National Center for Health Statistics. Update Prevalence of Overweight among children, adolescents and adults – United States. 1990-1998 MMWR Morb Mortal Wrkly Rep. 2001:50:166-169
6 Groves T. Pandemic obesity in Europe (editorial). BMJ. 2006, 331:1081.
7 National Institutes of Health, National Heart, Lung, and Blood Institute. Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults. Bethesda, MD: National Institutes of Health, National Heart, Lung, and Blood Institute; 1998; Publication 98-4083.
8 Pederson A. Obesity costs expected to quadruple to $344B by 2018. Medical Device Daily, 2009. Vol 13 No. 223.
9 Yong. L.R., Nestle M., Portion Sizes and Obesity: Responses of Fast-Food Companies. Journal of Public Health Policy 2007, 28, 238-248
10 Hogbin M, Shaw A, Anand RS, Nutrition Insights: Food Portions and Servings. How Do They Differ? Washington DC: US Dept of Agriculture; 1999.
11 Brownell, K.D. The environment and obesity. In C.G. Fiarburn & K.D. Brownell (Eds.). Eating disorders and obesity: A comprehensive handbook (2nd ed, pp 433-438) 2002. New York: Guilford Press.
12 Paul R., Kabnick K., Pete E., Fischler C. and Shields C. , The Ecology of Eating: Smaller Portion Sizes in France Than in the United States Help Explain the French Paradox.
13 Richard J.L., Les facteurs de risque coronarien:Le pardoxe francais. 1987 April. Archives des Maladies du Coeurs et des Vaisseaux 80, 17-21.