Is portion distortion making you fat?

Posted Monday, Aug. 18, 2014  comments  Print Reprints


Health experts talk a lot about “portion distortion,” a common situation in which restaurant entrees are supersized yet perceived by the public as single servings that ought to be consumed in one sitting. Americans are eating out more frequently than ever before while portion sizes have simultaneously increased at fast food and sit-down restaurants, and the American Heart Association calls it a “double whammy” that is causing waistlines to expand — nationwide. In a recent study titled “A Nation at Risk: Obesity in the United States,” the AHA reports that portion sizes have grown dramatically in the past 40 years and that today, Americans consume an average of 300 more calories per day than they did in 1985.

XTreme “winners”

CSPI officials say virutually every restaurant chain has viable contenders for its Xtreme Eating food overload awards, and this year, nearly all of the “winners” hit (or just missed) the 2,000-calorie mark — while a few belly bombs topped 3,000. The Cheesecake Factory was dubbed the winner of the XXXtreme Eating award since it took three of nine spots on the list. For a complete list, visit

Here’s a snapshot of a few:

Joe’s Crab Shack’s Big Hook Up platter. It’s got Great Balls of Fire (“seafood and crab balls full of jalapeños and cream cheese coated in panko breadcrumbs ... served with ranch dressing”), fish & chips (“flaky white fish hand dipped in a classic Samuel Adams beer batter ... served with fries”), coconut shrimp (“jumbo shrimp hand dipped in shredded coconut with pineapple plum sauce for dipping”), crab stuffed shrimp (“plump shrimp hand stuffed with crab”), hushpuppies and coleslaw. This “friedfoodaganza” comes to 3,280 calories (your fill for today and half of tomorrow), 50 grams of saturated fat and 7,610 milligrams of sodium (no more for you for the next five days). To burn that many calories, you’d have to play golf, sans a cart or caddie, for 11 straight hours.

The Cheesecake Factory’s farfalle with chicken and roasted garlic. Its tasty-looking cream sauce soaks a generous serving of chicken, pasta and veggies for a total of 2,410 calories and 63 grams of saturated fat (a three-day load). An equivalent? Five single-serve packages of Stouffer’s frozen Classics Chicken Fettuccini Alfredo, each topped with a pat of butter. (The farfalle has “only” 1,370 milligrams of sodium, a little less than a day’s worth.)

BJ’s Restaurant and Brewhouse’s s mall (9-inch) signature deep dish chicken bacon ranch pizza. More diminutive than BJ’s individual (11-inch) hand-tossed pizza and reportedly “lightly sauced,” it sounds reasonable with a description of grilled garlic chicken, applewood smoked bacon, jack and cheddar cheese, red onions, diced tomatoes and just a drizzle of ranch dressing. However, that translates to 2,160 calories on your plate, including 30 grams of saturated fat and 4,680 milligrams of sodium (three days’ worth). It is equal to three Pizza Hut personal pan pepperoni pizzas. You’d have to pedal your bike, nonstop, for 5 1/2 hours to burn the pizza off.

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We know we shouldn’t. We hate ourselves when we do. And yet, with all the information available about proper nutrition and the dangers of obesity, we still eat things like Red Robin’s A.1. peppercorn burger with bacon, bottomless steak fries and a monster salted caramel milkshake.

Recently, that meal combo captured one of nine “Xtreme Eating” awards from the Center for Science in the Public Interest (CSPI), clocking in with 3,540 calories (nearly two days’ worth for an average person), 69 grams of saturated fat (3.5 days’ worth) and 6,280 milligrams of sodium (about four days’ worth).

And it contains nothing short of 38 teaspoons of sugar, too.

Caloric totals like these for just one meal are pretty astounding no matter what your perspective or level of nutritional awareness, but the nonprofit health and advocacy organization’s report struck me as particularly noteworthy since I read it a day after returning home from two weeks in Japan, where human life expectancy rates are high and the obesity rate runs at a little over 3 percent — compared with about 35 percent in the United States.

According to the CIA’s World Factbook, Japanes citizens’ life expectancy is greater than that of residents of every other nation in the world except for tiny Monaco and the Chinese territory of Macau.

In comparison, the United States, despite our affluence and widespread access to the miracles of modern medicine, ranks 42nd on the life expectancy list. And our diets have a lot to do with that fact.

Certainly, we all understand that life expectancy is a complex mix of genetics, lifestyle and other factors, but the contrast between eating habits in the two nations is jolting (as is the knowledge that today’s children in the U.S. may be the first generation in 200 years to live shorter life spans than their parents).

I traveled most of Japan without seeing anything remotely akin to any of the Xtreme Eating award winners, including the Cheesecake Factory’s slab of peanut butter chocolate cake cheesecake (1,500 calories, 43 grams of saturated fat, 21 teaspoons of sugar).

The Japanese diet, as many know, is based heavily on rice and noodles, with plenty of vegetables and small bits of fish, chicken, pork or beef.

Japanese desserts are small by our standards and often consist of fruit. All of it is served in what Americans would consider tiny portions, on small plates or in small bowls, as opposed to our habits of heaping huge portions on one large plate.

On the Japanese island of Okinawa, home to a greater proportion of centenarians than anywhere in the world, many follow the practice of pushing away from a meal when they are 80 percent full. And, according to a 2006 study from the University of Minnesota, Americans consume an average of 230 more calories each day than the Japanese (2,168 vs. 1,930), and exercise much less — mainly because Japanese adults walk so much more as part of everyday life.

All of which raises the question: Why do so many of us still eat so poorly?

David Kessler, a former administrator of the Food and Drug Administration who wrote the influential book The End of Overeating, says the problem is a combination of the addictive salt, fat and sugar added to most foods, as well as social mores that allow the consumption of vast quantities. (Full disclosure: Kessler is on the board of the Center for Science in the Public Interest, though he had nothing to do with the recent report.)

Kessler’s research identifies the addictive quality of salt, fat and sugar, and points to a food industry that pushes it to keep us buying.

“If I give you fat, sugar and salt, and I can attract your attention and I can stimulate your affective circuitry,” he explains, adding, “and I can do that for the next 25 minutes while you’re eating this stuff — you’re not thinking about anything else.”

Jayne Hurley, a senior nutritionist at the CSPI who conducted the most recent study, says nearly half of Americans’ food dollars are now spent eating outside the home, and since most menus don’t disclose nutritional details, we don’t have a clue about how many calories we’re consuming.

“The bottom line is people just have no idea how many calories they’re eating,” and portions just keep getting bigger, she says. “I don’t think people know what a normal portion of food is. We’ve taught people that a drink is 32 ounces.”

For example, Hurley says muffins used to be about 2 ounces, but today, that’s dubbed “petite” or “bite-sized,” and the typical muffin serving has grown to 5 ounces.

When the organization started its food survey back in 2007, Hurley says, CSPI researchers were shocked to discover 1,500-calorie entrees. Today, however, she says most items on the Xtreme Eating list are in the 2,000 calorie range, and some reach 3,000.

Kessler and Hurley both say they have begun to see some restaurants offering smaller portions and putting some emphasis on healthful meal offerings, so change may be on its way. But, Kessler adds, it’s happening too slowly.

His advice? Society must begin to tackle “portion distortion” and the dominance of huge, unhealthful food portions in the restaurant industry in the same way that he and others went after the tobacco industry: by stripping away its cool, fun image and revealing it for the health hazard it is.

“I’d try to change the social norms,” he says. “I’d go after big food.

“And I would go after things that are sold as food when there’s no real food in it. It’s just highly processed fat, salt and sugar.”

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