title: Is there an association between food portion size and BMI among British adolescents?
abstract: The prevalence of obesity has increased simultaneously with the increase in the consumption of large food portion sizes (FPS). Studies investigating this association among adolescents are limited; fewer have addressed energy-dense foods as a potential risk factor. In the present study, the association between the portion size of the most energy-dense foods and BMI was investigated. A representative sample of 636 British adolescents (11-18 years) was used from the 2008-2011 UK National Diet and Nutrition Survey. FPS were estimated for the most energy-dense foods (those containing above 10·5 kJ/g (2·5 kcal/g)). Regression models with BMI as the outcome variable were adjusted for age, sex and misreporting energy intake (EI). A positive association was observed between total EI and BMI. For each 418 kJ (100 kcal) increase in EI, BMI increased by 0·19 kg/m2 (95 % CI 0·10, 0·28; P< 0·001) for the whole sample. This association remained significant after stratifying the sample by misreporting. The portion sizes of a limited number of high-energy-dense foods (high-fibre breakfast cereals, cream and high-energy soft drinks (carbonated)) were found to be positively associated with a higher BMI among all adolescents after adjusting for misreporting. When eliminating the effect of under-reporting, larger portion sizes of a number of high-energy-dense foods (biscuits, cheese, cream and cakes) were found to be positively associated with BMI among normal reporters. The portion sizes of only high-fibre breakfast cereals and high-energy soft drinks (carbonated) were found to be positively associated with BMI among under-reporters. These findings emphasise the importance of considering under-reporting when analysing adolescents' dietary intake data. Also, there is a need to address adolescents' awareness of portion sizes of energy-dense foods to improve their food choice and future health outcomes.
authors.affiliation: Nutritional Epidemiology Group, School of Food Science and Nutrition, Room G.07, Food Science Building, University of Leeds,LeedsLS2 9JT,UK.
authors.forename: Salwa A
authors.initials: SA
authors.lastname: Albar
authors.affiliation: Nutritional Epidemiology Group, School of Food Science and Nutrition, Room G.07, Food Science Building, University of Leeds,LeedsLS2 9JT,UK.
authors.forename: Nisreen A
authors.initials: NA
authors.lastname: Alwan
authors.affiliation: Nutritional Epidemiology Group, School of Food Science and Nutrition, Room G.07, Food Science Building, University of Leeds,LeedsLS2 9JT,UK.
authors.forename: Charlotte E L
authors.initials: CE
authors.lastname: Evans
authors.affiliation: Nutritional Epidemiology Group, School of Food Science and Nutrition, Room G.07, Food Science Building, University of Leeds,LeedsLS2 9JT,UK.
authors.forename: Janet E
authors.initials: JE
authors.lastname: Cade
mesh_terms: D000293:Adolescent; D017195:Adolescent Nutritional Physiological Phenomena; D001827:Body Height; D015992:Body Mass Index; D001835:Body Weight; D002253:Carbonated Beverages; D002648:Child; D002664:Child Nutritional Physiological Phenomena; D003611:Dairy Products; D015930:Diet Records; D004034:Diet Surveys; D004043:Dietary Fiber / Q000008:administration & dosage; D002523:Edible Grain; D002149:Energy Intake; D004739:England; D005260:Female; D005502:Food; D005518:Food Preferences; D006801:Humans; D008297:Male; D009749:Nutrition Surveys; D064787:Portion Size / Q000009:adverse effects