Socioeconomic position and the influence of food portion size on daily energy intake in adult females: two randomized control trials

Background. Large portions of energy-dense foods drive overconsumption and are more readily available in socioeconomically deprived areas. Reducing portion sizes of commercially available foods could be an effective public health strategy to reduce population energy intake, but recent research suggests that the effect portion size has on energy intake may differ based on socioeconomic position (SEP). Objective. We tested whether the effect of reducing food portion sizes on daily energy intake differed based on SEP. Methods. Participants were served either smaller or larger portions of food at lunch and evening meals (N = 50; Study 1) and breakfast, lunch and evening meals (N = 46; Study 2) in the laboratory on two separate days, in repeated-measures designs. The primary outcome was total daily energy intake (kcal). Participant recruitment was stratified by primary indicators of SEP; highest educational qualification (Study 1) and subjective social status (Study 2). Secondary indicators of SEP in both studies included household income, self-reported childhood financial hardship and a measure accounting for total years in education. Results. In both studies, smaller (vs larger) meal portions led to a reduction in daily energy intake (ps < .02). Smaller portions resulted in a reduction of 235kcal per day (95% CI: 134, 336) in Study 1 and 143kcal per day (95% CI: 24, 263) in Study 2. There was no evidence in either study that effects of portion size on energy intake differed by SEP. Results were consistent when examining effects on portion-manipulated meal (as opposed to daily) energy intake. Conclusion. Reducing meal portion sizes could be an effective way to reduce overall daily energy intake and contrary to other suggestions it may be a socioeconomically equitable approach to improving diet. These trials were registered at www.clinicaltrials.gov as NCT05173376 and NCT05399836.