The effectiveness of a social media intervention for reducing portion sizes in young adults and adolescents

open access journalAbstract Objective: Adolescents and young adults select larger portions of energy-dense food than recommended. The majority of young people have a social media profile, and peer influence on social media may moderate the size of portions selected. Methods: Two pilot-interventions examined whether exposure to images of peers’ portions of high-energy-dense (HED) snacks and sugar-sweetened-beverages (SSBs) on social media (Instagram) would influence reported desired portions selected on a survey. Confederate peers posted ‘their’ portions of HED snacks and SSBs on Instagram. At baseline and intervention end participants completed surveys that assessed desired portion sizes. Results: In intervention 1, Undergraduate students (N=20, Mean age=19.0y, SD=0.65y) participated in a two-week intervention in a within-subjects design. Participants reported smaller desired portions of HED snacks and SSBs following the intervention, and smaller desired portions of HED snacks for their peers. In intervention 2, adolescents (N=44, Mean age=14.4y, SD=1.06y) participated in a four-week intervention (n=23) or control condition (n=21) in a between-subjects design. Intervention 2 did not influence adolescents to reduce their desired reported portion sizes of HED snacks or SSBs relative to control. Conclusions: These preliminary studies demonstrated that social media is a feasible way to communicate with young people. However, while the intervention influenced young adults’ reported desired portions and social norms regarding their peers’ portions, no significant impact on desired reported portion sizes was found for HED snacks and SSBs in adolescents. Desired portion sizes of some foods and beverages may be resistant to change via a social media intervention in this age group

Reductions in entrée energy density increase children\u27s vegetable intake and reduce energy intake

The energy density (ED; kcal/g) of an entr&eacute;e influences children\u27s energy intake (EI), but the effect of simultaneously changing both ED and portion size of an entr&eacute;e on preschool children\u27s EI is unknown. In this within-subject crossover study, 3- to 5-year-old children (30 boys, 31 girls) in a daycare facility were served a test lunch once/week for 4 weeks. The amount and type of vegetables and cheeses incorporated into the sauce of a pasta entr&eacute;e were manipulated to create two versions that varied in ED by 25% (1.6 or 1.2 kcal/g). Across the weeks, each version of the entr&eacute;e was served to the children in each of two portion sizes (400 or 300 g). Lunch, consumed ad libitum, also included carrots, applesauce, and milk. Decreasing ED of the entr&eacute;e by 25% significantly (P &lt; 0.0001) reduced children\u27s EI of the entr&eacute;e by 25% (63.1 8.3 kcal) and EI at lunch by 17% (60.7 8.9 kcal). Increasing the proportion of vegetables in the pasta entr&eacute;e increased children\u27s vegetable intake at lunch by half of a serving of vegetables (P &lt; 0.01). Decreasing portion size of the entr&eacute;e by 25% did not significantly affect children\u27s total food intake or EI at lunch. Therefore, reducing the ED of a lunch entr&eacute;e resulted in a reduction in children\u27s EI from the entr&eacute;e and from the meal in both portion size conditions. Decreasing ED by incorporating more vegetables into recipes is an effective way of reducing children\u27s EI while increasing their vegetable intake.<br /

The feasibility and acceptability of two methods ofsnack portion control in United Kingdom (UK) preschool children: reduction and replacement.

Large portions of high energy dense (HED) snacks are offered to children from a young age and are pervasive in our food environment. This study aimed to explore the feasibility, acceptability, and preliminary efficacy of two strategies of snack portion control: reduction and replacement. Forty-six mother-child dyads aged 22⁻56 months (36.6 ± 9.5 m, 48% female) completed a three-week intervention. In week 1 (baseline) no changes were made to the child's diet; week 2 (acclimation) children received a standardised selection of HED snacks, and in week 3 (intervention) participants were randomly assigned to snack replacement (n = 24) or snack reduction (n = 22). Snack replacement involved swapping HED snacks for fruits and vegetables, whilst snack reduction involved reducing the size of HED snacks by 50%. Food and energy intake were measured using a weighed food diary for four consecutive days. Snack replacement resulted in more positive changes to children's diets; vegetable intake increased (p < 0.01), and total daily energy intake decreased when compared to snack reduction (p < 0.05). Mothers expressed a more favourable attitude to snack replacement, although snack reduction was also well received by mothers. Despite increased preliminary efficacy of snack replacement on dietary intake, both strategies were feasible and acceptable. The current pilot study provides the necessary information to inform the design of future interventions

Understanding the science of portion control and the art of downsizing

Offering large portions of high-energy-dense (HED) foods increases overall intake in children and adults. This is known as the portion size effect (PSE). It is robust, reliable and enduring. Over time, the PSE may facilitate overeating and ultimately positive energy balance. Therefore, it is important to understand what drives the PSE and what might be done to counter the effects of an environment promoting large portions, especially in children. Explanations for the PSE are many and diverse, ranging from consumer error in estimating portion size to simple heuristics such as cleaning the plate or eating in accordance with consumption norms. However, individual characteristics and hedonic processes influence the PSE, suggesting a more complex explanation than error or heuristics. Here PSE studies are reviewed to identify interventions that can be used to downsize portions of HED foods, with a focus on children who are still learning about social norms for portion size. Although the scientific evidence for the PSE is robust, there is still a need for creative downsizing solutions to facilitate portion control as children and adolescents establish their eating habits

Novel public-private partnerships to address the double burden of malnutrition

Public–private partnerships are an effective way to address the global double burden of malnutrition. While public–private partnerships operate in multiple forms, their leadership usually falls to governments, public health agencies, or nongovernmental organizations, with the private sector taking a subordinate role. The rapid ascent of social media and mass communications worldwide has provided a disruptive technology for new nutrition intervention programs. A new model, provisionally called private–public engagement, takes advantage of social media, mass media, and integrated social marketing to reach parents, families, and communities directly. These new private–public engagement initiatives need to be managed in ways suggested for public–private partnerships by the World Health Organization, especially if the private sector is in the lead. Once the rationale for engagement is defined, there is a need to mobilize resources, establish in-country partnerships and codes of conduct, and provide a plan for monitoring, evaluation, and accountability. Provided here is an example consistent with the private–public engagement approach, ie, the United for Healthier Kids program, which has been aimed at families with children aged less than 12 years. Materials to inspire behavioral change and promote healthier diets and lifestyle were disseminated in a number of countries through both digital and physical channels, often in partnership with local or regional governments. A description of this program, along with strategies to promote transparency and communication among stakeholders, serves to provide guidance for the development of future effective private–public engagements

Serving Larger Portions of Fruits and Vegetables Together at Dinner Promotes Intake of Both Foods among Young Children

Serving larger portions of energy dense foods has been shown to promote children’s energy intake at meals. Whether larger portions increase children’s intake of both fruits and vegetables (F&V) is less clear. A 2×2 within-subjects design systematically varied portion sizes of fruit (75 vs. 150 g) and vegetable (75 vs. 150 g) side dishes served at dinner. Children’s F&V liking was measured using a validated tasting method. Thirty 4- to 6-year-olds were tested in a laboratory setting at 5:00 PM on weekdays from November 2008 through March 2009. Mixed linear models were used to determine effects of fruit portion size, vegetable portion size, and their interaction on food and energy intakes. Data are presented as model-based means ± standard error unless otherwise indicated. When portions were doubled, children increased their vegetable intake by 37% (12 ± 4 g;

Colour as a cue to eat : effects of plate colour on snack intake in pre-school children

Environmental cues, such as the colour of food and dishware, have been shown to influence food and drink consumption in adult populations. This proof of concept study investigated whether plate colour could be utilised as a strategy to reduce intake of high energy density (HED) snacks and increase intake of low energy density (LED) snacks in pre-school children. In a between and within-subjects design, children were randomly assigned to either a control group (no colour message) or intervention group (received a colour message: red = stop, green = go) and were provided a snack at nursery on three occasions on differently coloured plates (red, green and white), for each snack type (HED, LED). Snack intake, colour preference, colour association, and anthropometrics were recorded for each child. The results showed that there was no effect of group (control vs intervention) on HED (p=0.540) and LED intake (p=0.575). No effect of plate colour on HED (p=0.147) or LED snack intake (p=0.505) was evident. Combining red and green plates for a chromatic versus achromatic comparison showed that there was no significant effect of chromatic plate on HED (p=0.0503) and LED (p=0.347) intakes. Despite receiving a brief learning intervention, the use of plate colour was found in the present study to be an ineffective strategy to control snack food intake in pre-school aged children. Rather, we suggest that food intake in young children may best be predicted by portion size, energy density and eating behaviour traits

Set points, settling points and some alternative models: theoretical options to understand how genes and environments combine to regulate body adiposity

The close correspondence between energy intake and expenditure over prolonged time periods, coupled with an apparent protection of the level of body adiposity in the face of perturbations of energy balance, has led to the idea that body fatness is regulated via mechanisms that control intake and energy expenditure. Two models have dominated the discussion of how this regulation might take place. The set point model is rooted in physiology, genetics and molecular biology, and suggests that there is an active feedback mechanism linking adipose tissue (stored energy) to intake and expenditure via a set point, presumably encoded in the brain. This model is consistent with many of the biological aspects of energy balance, but struggles to explain the many significant environmental and social influences on obesity, food intake and physical activity. More importantly, the set point model does not effectively explain the &lsquo;obesity epidemic' - the large increase in body weight and adiposity of a large proportion of individuals in many countries since the 1980s. An alternative model, called the settling point model, is based on the idea that there is passive feedback between the size of the body stores and aspects of expenditure. This model accommodates many of the social and environmental characteristics of energy balance, but struggles to explain some of the biological and genetic aspects. The shortcomings of these two models reflect their failure to address the gene-by-environment interactions that dominate the regulation of body weight. We discuss two additional models - the general intake model and the dual intervention point model - that address this issue and might offer better ways to understand how body fatness is controlled

Reward vs non-reward sensitivity of the medial vs lateral orbitofrontal cortex relates to the severity of depressive symptoms

Background: The orbitofrontal cortex (OFC) is implicated in depression. The hypothesis investigated was whether the OFC sensitivity to reward and non-reward is related to the severity of depressive symptoms. Methods: Activations in the monetary incentive delay task were measured in the IMAGEN cohort at age 14 (n=1877) and 19 (n=1140) with a longitudinal design. Clinically-relevant subgroups were compared at age 19 (high-severity group n=116; low-severity group n=206), and 14. Results: The medial OFC exhibited graded activation increases to reward; and the lateral OFC had graded activation increases to non-reward. In this general population, the medial and lateral OFC activations were associated with concurrent depressive symptoms at both age 14 and 19. In a stratified high-severity depressive symptom vs control comparison, the lateral OFC showed greater sensitivity for the magnitudes of activations related to non-reward (No-Win) in the high-severity group at age 19 (p=0.027), and the medial OFC showed decreased sensitivity to the reward magnitudes in the high-severity group at both age 14 (p=0.002) and 19 (p=0.002). In a longitudinal design, there was greater sensitivity to non-reward of the lateral OFC at age 14 for those who exhibited high depressive symptom severity later at age 19 (p=0.003). Conclusions: Activations in the lateral orbitofrontal cortex relate to sensitivity to not winning, were associated with high depressive symptom scores, and at 14 predicted the depressive symptoms at 16 and 19. Activations in the medial OFC were related to sensitivity to winning, and reduced reward sensitivity was associated with concurrent high depressive symptom scores