Systematic studies have shown that providing individuals with larger portions of foods and beverages leads to substantial increases in energy intake. The effect is sustained over weeks, supporting the possibility that large portions have a role in the development of obesity. The challenge is to find strategies to effectively manage the effects of portion size. One approach involves teaching people to select appropriate portions and to use tools that facilitate portion control. Although tools such as portion-control plates have been shown in several randomized trials to improve weight loss, limited data are available on whether education and tools lead to long-term changes in eating behavior and body weight. Another approach is to use preportioned foods (PPFs) to add structure to meals and minimize decisions about the amount of food to eat. A number of randomized controlled trials have demonstrated the efficacy of both liquid meal replacements and solid PPFs for weight loss and weight loss maintenance, but it is not known if they lead to better understanding of appropriate portions. Although portion control is important for weight management, urging people simply to ‘eat less' of all foods may not be the best approach as high-energy-dense foods disproportionately increase energy intake compared with those lower in energy density. A more effective strategy may be to encourage people to increase the proportion of foods low in energy density in their diets while limiting portions of high-energy-dense foods. If people lower the energy density of their diet, they can eat satisfying portions while managing their body weight.
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