Auburn University/Auburn Montgomery

Nicole OverstreetPortion and Serving Sizes1OutlineBackgroundPortion SizeServing SizePopulationDesignTannahill Model of Health PromotionProject ImplementationEvaluation

2BackgroundMore than 1.5 billion people in the world are overweight or obese and this can be attributed to a dramatic increase in portion sizes and lack of attention paid to serving sizes.The United States has the worlds highest obesity rates. Obesity is associated with an increased risk of developing many different health conditions.

In the US, 34% of adults and 17% children between the ages of 2-19 years. Heart disease, hypertension, type 2 diabetes, hyperlipidemia, ischemic stroke, cancer, and sleep apnea. As you can probably guess, the steady rise of obesity throughout the world has become a global epidemic.

3Portion Size Portion size- the amount of food that is offered or purchased and then consumed.Throughout the years, portion sizes have increased substantially both inside and outside the home. McDonalds hamburgers and French fries are 2-5 times larger than they were in the 1950s. Portion distortion

Back then, only 7oz cups were offered and today, consumers can choose from 12, 16, 21, or 32oz cups. Portion distortion is a recent phenomenon that is not having the ability to appropriately determine what an individual should consume in one sitting.4Serving SizeServing size is regulated by the Food and Drug Administration (FDA) and varies from product to product. Frequently over estimated.A few everyday common items can be visualized to help figure out a serving size of certain foods.

- The FDA and product manufacturer work together to decide on what constitutes as a healthy serving of that product. 5

6PopulationTarget population- AdultAdult population consists of individuals ranging from 18 years of age to 64 years of age.Many health problems are complicated, if not caused by weight.The adult population is at a stage in their lives where they can understand disease risk factors and symptoms but at the same time are able to still take measures to prevent or control the disease.

After collaborating with my preceptor, it was decided that the population that would most benefit from this health promotion project would be the adult population.This was my target population because globally over 1.5 billion adults are overweight and about 500 million are obese. 7DesignDesigned to bring knowledge about serving sizes, portion sizes, and obesity facts to the adult population. Teach patients common household items that they can visualize as to what constituents a serving size of different food groups. Teach patient to use a smaller lunch plate instead of the huge dinner plates.

Again, the increase of portion sizes and serving sizes that people usually consume is directly related to the rates of overweight and obese people worldwide. This will give patients the tools for weight loss or weight management and give the patient confidence in being pro-active in their own health. Throughout the last few decades, normal dinner plate have grown substantially. They use to be 9inches and today a dinner plate in roughly 12inches. People have become accustom to eating more simply because more food is required to fill the standard plate nowadays. Individuals perceive that they need to eat all the food on their plates and therefore, consume too many calories, which leads to additional weight gain. By eating off of smaller plates, smaller portions are given because the plate as a whole will hold less and it tricks the mind into thinking that less food needs be consumed.

8Tannahill Model of Health Promotion

This model consists of three overlapping, interconnected circles that each plays a part in health promotion. 1st circle is health education. Patients need to be educated on what are proper serving sizes and portion sizes.2nd circle is prevention. Studies have shown that there is a relationship between obesity and developing later in life hypertension, diabetes, cardiovascular disease, and etc. and that prevention is of paramount importance. 3rd circle is health protection and is extremely similar to the other 2 components of the model. Health protection involves adults gaining knowledge so that prevention of health complications does not occur due to being overweight or obese. This allows the adult to be pro-active and protect their own health. 9Project ImplementationFamily practice officeHandout that discusses obesity, increased risk of disease, and portion/serving size control. Annual physical examinationsBrief overview about the project > gave educational handout > discussed handout > any questions or clarifications

10-15 physicals a day for 1 doctor. Physical examinations are allotted a considerable more amount of time than sick or other office visits. This allows an adequate amount of time for the project to be implemented on an individual base. The patients overall health and well-being is also thoroughly discussed at the annual physical examination. Giving the patient plenty time to think of/ask questions, is a huge part of this project implementation.10Evaluation11 PatientsAverage of 4 minutes spent with each patientSuccess!1 handout was found in the trash Changes:Target populationTimeSeven of the patients were female and the other four were male. The patients ranged from thirty-one years of age to sixty-two years of age.Overall, the project was a success! People interacted with me and asked many questions. The part of the project implementation that was received the best was the chart that showed visual aids equivalent to serving sizes of different foods. Many patients said that they would put this handout on their refrigerator or in their purse/wallet so they could refer back to it while eating. The target population should be expanded to all patients seen. For example, 1 patient was in to discuss weight loss and many patients came in for HTN or DM checks and the information in this project would have benefitted all of those patients. As much time as possible was given to the patients to ask questions but it still felt like we were rushing them. Healthcare providers battle with this issue on a daily basis. If another minute or two could be dedicated to each patient, it is believed that patients would not be rushed and able to ask every question possible.

11ReferencesClemons, R. (2012). Portion distortion. Choice (0009-496X), 28. Mohr, G., Lichtenstein, D., & Janiszewski, C. (2012). The effect of marketer-suggested serving size on consumer responses: The unintended consequences of consumer attention to calorie information. Journal Of Marketing, 76(1), 59-75. doi:10.1509/jm.10.0073Nguyen, T., & Lau, D. (2012). The obesity epidemic and its impact on hypertension. The Canadian Journal Of Cardiology, 28(3), 326-333. doi:10.1016/j.cjca.2012.01.001Pratt, I., Croager, E., & Rosenberg, M. (2012). The mathematical relationship between dishware size and portion size. Appetite, 58(1), 299-302. doi:10.1016/j.appet.2011.10.010Shah, M., Adams-Huet, B., Elston, E., Hubbard, S., & Carson, K. (2010). Food serving size knowledge in African American women and the relationship with body mass index. Journal Of Nutrition Education And Behavior, 42(2), 99-105. doi:10.1016/j.jneb.2009.02.001Tannahill, A. (2009). Health promotion: The Tannahill model revisited. Public Health (Elsevier), 123(5), 396-399. doi:10.1016/j.puhe.2008.05.021Vermeer, W. M., Steenhuis, I. M., & Seidell, J. C. (2010). Portion size: A qualitative study of consumers attitudes toward point-of-purchase interventions aimed at portion size. Health Education Research, 25(1), 109-120. doi:10.1093/her/cyp051

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