My latest paper: portion size

My former doctoral student and now colleague Lisa Young has been tracking the increase in portion sizes of junk foods for more than 20 years.  Our latest report has just come out in the American Journal of Public Health: Portion Sizes of Ultra-Processed Foods in the United States, 2002 to 2021.

At first introduction, most companies offered products in just 1 size; that size is smaller than or equal to the smallest size currently available. For example, the original size of a Coca-Cola bottle was 6.5 ounces; today it comes in 6 sizes marketed as single servings; these range from 7.5 ounces to 24 ounces, 4 of which have been introduced since 2002.

Since 2002, McDonald’s has reduced the sizes of its french fries and eliminated its “supersize” french fries and soda, but still offers quart-sized sodas and double burgers. While McDonald’s and Burger King decreased the size of their largest portion of french fries, they increased the sizes of their smallest portions. While Burger King reduced the sizes of it’s hamburger sandwiches, since 2002 they added a triple Whopper.

• Have more calories (if only this were intuitively obvious, but it is not)
• Encourage people to eat more
• Confuse people about how much they are eating

Our recommendations:

We think it is time to also consider caps and other legislatively mandated national policy options to require the food industry to make smaller food portions more available, convenient, and inexpensive:

•  offer consumers price incentives for smaller portions of ultra-processed foods,

•  discontinue the largest sizes of ultra-processed packaged foods and fast-food portions, and

•  restrict marketing of large portions of ultra-processed foods, especially those targeted to children and minorities.

Our article is accompanied by an editorial by Carlos Monteiro and Geoffrey Cannon, the inventors of the term, “ultra-processed”: Yes, Food Portion Sizes and People Have Become Bigger and Bigger. What Is to Be Done? 

Their point: reducing portion sizes is unlikely to work internationally.

In such countries, reduced portion sizes of ultra-processed foods would at best have limited effect, and most likely would be counterproductive if they were marketed to promote their consumption. Generally, the most rational guideline, for global as well as personal health and well-being, is to protect and promote minimally processed foods and freshly prepared meals and to discourage the consumption of ultra-processed foods altogether, together with statutory measures including fiscal policies and actions. These measures should make fresh and minimally processed foods cheaper and more available. Ultra-processed foods should be made more expensive and less available, if at all, especially in canteens and hospitals, other health settings, and in and near schools. Cosmetic additives should be banned or highly taxed.

We have much work to do.