Diet & Fitness News

Some Accept 'Downsizing' at Restaurants

by Lori Wiviott Tishler, M.D.
Harvard Medical School

Americans will sometimes accept a smaller portion in a restaurant to save calories, a new study suggests. And they might even be willing to pay the same price. The study was done by two business professors, not doctors. The setting was a Chinese food restaurant in a hospital. As they went through the serving line, people were asked if they wanted a half-size portion of the rice or noodles that went with the main course. The server told them this would save 200 calories. Some people were offered 25 cents off for choosing the smaller portion. Others got no discount at all. Depending on the day, 14% to 33% of the customers chose the half-size portion. The discount made no difference in how many people accepted. Researchers also weighed the leftovers. They found that people who took half-size portions left just as much food on their plates as those who took full portions. The journal Health Affairs published the study. The Associated Press (AP) wrote about it February 13. Researchers told AP that other studies suggest people will eat less if they use smaller plates in colors that contrast with the food.

What Is the Doctor's Reaction?

If you look at a group of three adults in the United States, two of them are going to be classified as overweight or obese. The epidemic of excess weight in our nation is startling and very worrisome.

Obesity can lead to an increase in chronic (long-lasting) health conditions. These include diabetes, high blood pressure and heart disease. Diabetes can also cause earlier arthritis and many other problems.

Most doctors spend time counseling patients about diet and exercise. No one likes to diet. Many patients tell me that they eat out a lot and may not have time to really think about portion size.

Restaurant portions (both fast food and other types of restaurants) have greatly increased in the last 20 years. We can probably all agree that portions are large in restaurants. Yet most of us will eat whatever's in front of us.

This study, published in the journal Health Affairs, addressed this issue in a clever way. The setting was a Chinese restaurant. Patrons were offered either the usual portions of rice or noodles or half-size portions. Some clients were offered a small price break on the half-size portions. Others paid the standard price.

The authors found that 14% to 33% of the patrons chose to downsize their carbs, regardless of the price.

This is an important result. The restaurant industry sees increased portions as a relatively easy way to increase customers' perception of value. If restaurants learn that improving health also improves perceived value, the public health benefits (and restaurant profits) could increase together!

It is worth noting that the smaller portions had about 200 fewer calories in their meal. And they still often left food on their plates. Therefore, they consumed even fewer calories.

Keep in mind that 3,500 calories is equal to 1 pound. So a sustained effort to cut 200 calories a day would lead to 1-pound weight loss in just over 2 weeks. That's slower than some people would like, but painless and steady.

This study was interesting for several reasons. It wasn't a medical study, but done by a professor of business. It suggests that:

• There are clever, socially acceptable ways to reach out to people who are eating too much
• People are willing to have a smaller amount of food
• The suggestion to eat less -- from the waiter -- was a welcome one

This study also may help businesses to realize that healthy ideas sell food -- in this case, just as well as an overflowing plate!

What Changes Can I Make Now?

There is no magic to weight loss. Eat less. Exercise more.

Yet you can be quite creative, like the authors of this study. Here are a few suggestions:

• Trick your eyes. Instead of using a large plate, use a smaller one. Consider either a salad plate or a child-sized plate.
• At a restaurant, share with a friend, or ask for an appetizer-sized portion of your entrée.
• Don't drink your calories. Be cautious with sugary sodas and premium drinks from coffee houses and bakeries.
• Exercise with your friends. Two of my friends -- living a country apart -- have set a walking goal for February. They are cheering each other on, even if they can't share a sidewalk.
• Remember that you don't have to finish everything on your plate!

If you have any specific health problems or want more details about a specific eating plan, your primary care doctor is a good place to start. Working with a nutritionist (covered by some health plans) or a safe, effective diet program can be good as well. Of course, you know what to do, but having some support to do it is a wonderful thing!

What Can I Expect Looking to the Future?

I liked this study because it's simple and creative. It's easy to say that we all have to take personal responsibility, especially for things like weight gain. We do, of course. But I would love to see more studies like this one that merge public health and medicine with our real, complicated lifestyles. I think great changes could occur.

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