Association of Overweight with Food Portion Size among Adults of São Paulo – Brazil

BackgroundAlthough studies show that portion size affects energy intake, few have demonstrated a link between portion size and weight status, especially in free-living populations. The objective of the present study was to assess the relationship between food portion sizes and overweight in a representative population of adults of São Paulo, Brazil.MethodsCross-sectional population-based study with 1005 adults from São Paulo, Brazil. Dietary data were obtained from two 24-hour recalls. Reported foods were classified into groups and energy contribution, prevalence of consumers and portion sizes were calculated. Individuals were classified according to BMI in with and without overweight. Logistic regression models were used to evaluate the association between food portion sizes and being overweight.ResultsThe most consumed food groups were: beans, breads/rolls, coffee/tea, milk, rice, and sugar. Rice, red meat, breads/rolls, and white meat were the groups with the highest percentage of contribution to total energy intake. Butter/margarine, toasts/biscuits, sugar, and cakes were the groups with the highest energy density. After adjustment for confounding variables, overweight was associated with larger portions of pizza (OR = 1.052; p = 0.048), red meat (OR = 1.025; p = 0.043), rice (OR = 1.033; pConclusionsLarger portions of few food groups with different energy densities were associated with being overweight, suggesting that overweight may be related to the consumption of larger portion sizes of a series of food groups, not a food group alone. Additionally, we highlight the importance of considering underreporting as a confounding factor in these associations.研究背景 尽管已有研究表明食物分量可影响能量摄入，但鲜有研究证实食物分量与体重状态之间存在关联，尤其是在自由生活人群（free-living populations）中。本研究旨在评估巴西圣保罗成年代表性人群中食物分量与超重的关联。 研究方法 本研究为基于人群的横断面研究，共纳入巴西圣保罗的1005名成年人。膳食数据通过两次24小时膳食回顾法（24-hour recalls）获取。将报告摄入的食物进行分组，并计算各组的能量贡献、消费者占比及食物分量。根据身体质量指数（BMI）将研究对象分为超重与非超重两组。采用logistic回归模型分析食物分量与超重之间的关联。 研究结果 摄入频次最高的食物组别为豆类、面包/餐包、咖啡/茶、牛奶、大米及食糖。大米、红肉、面包/餐包与白肉是总能量摄入占比最高的食物组别。黄油/人造黄油、烤面包/饼干、食糖与蛋糕则是能量密度最高的食物组别。在对混杂变量进行校正后，超重与更大分量的披萨（比值比OR=1.052；P=0.048）、红肉（OR=1.025；P=0.043）及大米（OR=1.033；p）存在关联。 研究结论 少数能量密度各异的食物组别摄入分量更大与超重相关，这表明超重可能与一系列食物组别的较大分量摄入有关，而非仅与单一食物组别相关。此外，本研究强调在这类关联分析中，将膳食报告不足（underreporting）作为混杂因素纳入考量的重要性。