Trevor Hancock: Portion size: The elephant in the room

By now, everybody knows we are in the midst of an epidemic of overweight and obesity in Canada and around the world. There is a horrifying series of maps showing the rate of obesity spreading like a red stain across Canada over the past 30 years.

In its latest fact sheet, the World Health Organization reports that “worldwide obesity has nearly doubled since 1980” and that “35 per cent of adults aged 20 and over were overweight in 2008, and 11 per cent were obese.”

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In Canada, it is much the same. The Public Health Agency of Canada reported in 2011 that obesity rates had roughly doubled between 1981 and 2008. In 2013, the self-reported body mass index of 62 per cent of men and 45 per cent of women over age 18 revealed they were overweight or obese.

The cause is not hard to find. In a nutshell, too much food in, not enough calories out (in the form of physical activity).

But the really interesting question is, why did our food intake increase so much?

The standard explanation is that we are weak-willed and self-indulgent. If we just said no to extra calories, all our problems — along with our excess weight — would dissolve away.

How well is that working for you? Probably as well as it works for me — it’s easy to lose weight. I have done it often!

So why do we eat more, even when we know we shouldn’t? Let’s go a bit further upstream, because the elephant in the room is portion size, combined with marketing.

In a 2007 article in the Journal of the American Dietetic Association, the authors pulled the various strands together and found everything has gotten bigger. The size of packages, tins and bottles in supermarkets has increased; there are larger portion sizes in restaurants. Even the size of our plates and bowls at home and the servings in our cookery books have increased. Specifically, they reported that:

• The number of larger sizes of packaged foods in supermarkets increased 10-fold between 1970 and 2000.

• Super-sized portions in restaurants are consistently two-and-a-half times larger than regular portions.

• The surface area of dinner plates has increased by an average of one-third since 1960.

• In the 2006 edition of the Joy of Cooking, the serving size of some entrées has increased by as much as 42 per cent from some recipes in the first edition of 1931.

The food industry has both bought into and encouraged the general North American view that bigger is better. And if your customers believe that, then for a marginal cost (the food in your meal is only a small part of the overall cost), they can offer you more and make you happy — and overweight.

The growth in portion size is considerable. The U.S. National Heart, Lung and Blood Institute, in reporting on “portion distortion,” noted that the average number of calories in a cheeseburger in the U.S. went from 333 to 590 in the past 20 years, while the average in a portion of fries went from 210 to a whopping 610, and the average in a turkey sandwich from 320 to a gargantuan 820 calories.

So what can we do about this? First, while regulation and taxation are favourite public-health strategies (because they work — think of tobacco), I see little likelihood that governments will start to tax or regulate portion size in the foreseeable future. What they can and should regulate is putting calorie counts on the menus.

Even better, put the number of kilometres the average person would have to walk to burn off those calories — that is a real-world measure I can relate to. For example, you would need to walk about 10 kilometres to burn off the cheeseburger, another 10 kilometres for the fries and 13 kilometres for the turkey sandwich. This at a time when our lifestyle has become more sedentary.

We must also rely on the power of persuasion. We should all ask our food providers to offer smaller sizes, or we should order the child size. We can order one portion and two plates and ostentatiously split the meal with a partner, or take half home, so they can see they are only making one sale for two meals.

Perhaps there should even be “We want less” pickets of some fast-food chains. Whatever we do, we need to make the elephant in the room smaller.

 

Dr. Trevor Hancock is a professor and senior scholar at the University of Victoria’s school of public health and social policy.

thancock@uvic.ca

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