title: A qualitative study of psychological, social and behavioral barriers to appropriate food portion size control.
abstract: BACKGROUND
  Given the worldwide prevalence of overweight and obesity, there is a clear need for meaningful practical healthy eating advice - not only in relation to food choice, but also on appropriate food portion sizes. As the majority of portion size research to date has been overwhelmingly quantitative in design, there is a clear need to qualitatively explore consumers' views in order to fully understand how food portion size decisions are made. Using qualitative methodology this present study aimed to explore consumers' views about factors influencing their portion size selection and consumption and to identify barriers to appropriate portion size control.
  
  
  METHODS
  Ten focus groups with four to nine participants in each were formed with a total of 66 persons (aged 19-64 years) living on the island of Ireland. The semi-structured discussions elicited participants' perceptions of suggested serving size guidance and explored the influence of personal, social and environmental factors on their food portion size consumption. Audiotapes of the discussions were professionally transcribed verbatim, loaded into NVivo 9, and analysed using an inductive thematic analysis procedure.
  
  
  RESULTS
  The rich descriptive data derived from participants highlight that unhealthy portion size behaviors emanate from various psychological, social and behavioral factors. These bypass reflective and deliberative control, and converge to constitute significant barriers to healthy portion size control. Seven significant barriers to healthy portion size control were apparent: (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.
  
  
  CONCLUSIONS
  Portion size control strategies should empower consumers to overcome these effects so that the consumption of appropriate food portion sizes becomes automatic and habitual.
authors.affiliation: Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Belfast, UK.
authors.forename: Michelle
authors.initials: M
authors.lastname: Spence
authors.forename: M Barbara E
authors.initials: MB
authors.lastname: Livingstone
authors.forename: Lynsey E
authors.initials: LE
authors.lastname: Hollywood
authors.forename: Eileen R
authors.initials: ER
authors.lastname: Gibney
authors.forename: Sinéad A
authors.initials: SA
authors.lastname: O'Brien
authors.forename: L Kirsty
authors.initials: LK
authors.lastname: Pourshahidi
authors.forename: Moira
authors.initials: M
authors.lastname: Dean
mesh_terms: D000328:Adult; D001288:Attention; D004644:Emotions; D002149:Energy Intake; D005247:Feeding Behavior / Q000523:psychology; D005260:Female; D017144:Focus Groups; D017408:Guidelines as Topic; D006167:Guilt; D015438:Health Behavior; D006801:Humans; D007494:Ireland; D008297:Male; D008875:Middle Aged; D010465:Perception; D036301:Qualitative Research; D012201:Reward; D012927:Social Control, Informal; D012931:Social Environment; D055815:Young Adult
references.citation: Am J Clin Nutr. 2004 Jun;79(6):962-8
references.pmid: 15159224
references.citation: Obesity (Silver Spring). 2010 Feb;18 Suppl 1:S13-6
references.pmid: 20107455
references.citation: Proc Nutr Soc. 2011 May;70(2):155-61
references.pmid: 21275082
references.citation: PLoS Med. 2011 Jun;8(6):e1001050
references.pmid: 21738451
references.citation: Z Gesundh Wiss. 2010 Jun;18(3):261-277
references.pmid: 21124644
references.citation: Annu Rev Nutr. 2004;24:455-79
references.pmid: 15189128
references.citation: Ann Behav Med. 2009 Dec;38 Suppl 1:S4-17
references.pmid: 19787308
references.citation: Psychol Bull. 1994 Jul;116(1):117-42
references.pmid: 8078969
references.citation: Int J Behav Nutr Phys Act. 2009 Aug 21;6:58
references.pmid: 19698102
references.citation: Pers Soc Psychol Bull. 2011 Nov;37(11):1428-37
references.pmid: 21859902
references.citation: J Am Diet Assoc. 2000 Feb;100(2):232-4
references.pmid: 10670398
references.citation: Am J Clin Nutr. 2007 Dec;86(6):1709-16
references.pmid: 18065590
references.citation: Public Health Nutr. 2012 Nov;15(11):2110-7
references.pmid: 22717044
references.citation: JAMA. 2003 Jan 22-29;289(4):450-3
references.pmid: 12533124
references.citation: J Am Diet Assoc. 2006 Dec;106(12):1984-90; discussion 1990-1
references.pmid: 17126628
references.citation: Int J Behav Nutr Phys Act. 2007 Jun 27;4:27
references.pmid: 17597516
references.citation: Am J Clin Nutr. 2002 Dec;76(6):1207-13
references.pmid: 12450884
references.citation: Public Health Nutr. 2012 Mar;15(3):518-26
references.pmid: 21914255
references.citation: Obes Res. 2005 Jan;13(1):93-100
references.pmid: 15761167
references.citation: Proc Nutr Soc. 2012 Nov;71(4):610-21
references.pmid: 22877767
references.citation: Obesity (Silver Spring). 2007 Jun;15(6):1535-43
references.pmid: 17557991
references.citation: J Nutr Educ Behav. 2005 Sep-Oct;37(5):242-5
references.pmid: 16053812
references.citation: Obes Res. 2004 Mar;12(3):562-8
references.pmid: 15044675
references.citation: J Nutr. 2004 Oct;134(10):2546-9
references.pmid: 15465745
references.citation: Br J Soc Psychol. 2008 Jun;47(Pt 2):245-65
references.pmid: 17678574
references.citation: Psychol Bull. 2006 Mar;132(2):249-68
references.pmid: 16536643
references.citation: Appetite. 2009 Apr;52(2):340-4
references.pmid: 19071169
references.citation: J Am Diet Assoc. 1997 Oct;97(10):1122-32
references.pmid: 9336559
references.citation: J Am Diet Assoc. 2004 Mar;104(3):367-72
references.pmid: 14993858
references.citation: J Am Diet Assoc. 2006 Apr;106(4):543-9
references.pmid: 16567150
references.citation: J Nutr. 2005 Apr;135(4):905-9
references.pmid: 15795457
references.citation: Appetite. 2004 Feb;42(1):63-9
references.pmid: 15036784
references.citation: J Am Diet Assoc. 2004 May;104(5):804-6
references.pmid: 15127068
references.citation: Psychol Sci. 2006 Jun;17(6):521-5
references.pmid: 16771803