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Symposium: Modifying the Food Environment: Energy Density, Food Costs, and Portion Size

How to Modify the Food Environment¹

Nutritional Sciences Program, School of Public Health and Community Medicine, University of Washington, Seattle, WA and ^* Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA

²To whom correspondence should be addressed. E-mail: adamdrew{at}u.washington.edu.

Most researchers would agree that obesity has become an environmental issue (1). The current food environment effectively promotes energy intakes, whereas the physical environment limits opportunities for energy expenditure (2,3). Some believe that agricultural policies (4), food supply trends (5), food distribution and marketing practices (6), and the eating environment (7) are responsible for the current obesity epidemic. However, there is little consensus on what ought to be done. Approaches to weight control, traditionally based on nutrition education and individual behavioral change, have now been supplemented by calls for policy overhaul, sin taxes on "unhealthy" foods, and the threat of legal action against segments of the food industry. Studies on the food environment have taken on a new significance. Any public policy interventions need to be grounded in sound nutritional and behavioral science.

This symposium explored those aspects of the food environment that, we believe, present the most severe challenge to biological mechanisms regulating food intake. Speakers outlined current dietary trends, suggesting ways in which biological and behavioral sciences can work together with epidemiology and public health. The National Institutes of Health and other funding agencies have emphasized community-based participatory research and are increasingly demanding more attention to the public health and policy aspects of the obesity problem. At the same time, there is a grassroots movement nationwide to promote better nutrition in schools that is supported by government agencies and that may affect commercial interests. Nutrition professionals are increasingly being asked to contribute opinion and advice not only on scientific but also on policy matters.

Understanding how consumers make food choices is a prerequisite in nutrition intervention research. Obesity is the outcome of interactions between biological factors and the environment, including the social, economic, and physical environment. Consumer food choices are based on taste, cost, and convenience. The accessibility and affordability of foods play a role in determining healthy choices. The following articles address the impact of dietary energy density (kJ/g), energy costs ($/MJ), portion sizes, and away-from-home foods on energy intakes and excessive weight gain.

Ledikwe et al. (8) address the influence of portion sizes, food packaging, and energy density on energy intakes under both laboratory and naturalistic conditions. Large portions of energy-dense foods have been suggested to increase energy intake and may be one factor responsible for the obesity epidemic. Questions that will be addressed are: 1) Do large portions influence energy intake? 2) Do the effects of portion size persist beyond a single meal? 3) Does limiting portion size have an impact on energy intake and body weight? and 4) How can effects of portion size on energy intake be moderated?

Drewnowski and Darmon (9) describe the relationship between diet structure and estimated diet costs, using data from both the U.S. and France. Economic analyses of the relationship between energy density, sugar and fat intakes, and the estimated diet costs suggest that the recommended healthier diets cost more. Given the current hierarchy of food prices, diets based on lean meats, vegetables, and fruit tend to be associated with higher diet costs than high energy-density diets rich in added sugars and fats. Dietary energy density is inversely associated with diet costs, such that low energy density diets tend to cost more. Imposing a cost constraint in a linear programming model leads to higher-fat and higher energy-density diets. Because "prudent" diets are likely to cost more, diet costs are one likely barrier to healthy eating among minority communities and the poor. Further studies on economic factors influencing eating behaviors are needed to complement current and behaviorally-oriented research on dietary change.

Environmental interventions in schools and workplaces are reviewed in the next article. French (10) summarizes some of her studies on the impact on changing snack prices in vending machines on the consumption of lower-fat foods. She addresses ways of improving the schools food environment through a combination of healthier competitive foods, peer promotion, and price intervention at vending machines.

On a larger scale, Kennedy (11) reviews global nutrition trends and the outlook for the future. Rapidly evolving diets and the nutrition transition indicate that obesity will soon become not a national but a global problem. World Health Organization initiatives and guidelines are beginning to address this issue (12), as obesity rates are increasing rapidly in developing nations, where hunger and overweight coexist.

	FOOTNOTES

 
¹ Presented as part of the symposium "Modifying the Food Environment: Energy Density, Food Costs, and Portion Size" given at the 2004 Experimental Biology meeting on April 19, 2004, Washington, DC. The symposium was sponsored by the American Society for Nutritional Sciences and was supported in part by an unrestricted educational grant from Campbell Soup Company. The proceedings are published as a supplement to The Journal of Nutrition. This supplement is the responsibility of the Guest Editors to whom the Editor of The Journal of Nutrition has delegated supervision of both technical conformity to the published regulations of The Journal of Nutrition and general oversight of the scientific merit of each article. The opinions expressed in this publication are those of the authors and are not attributable to the sponsors or the publisher, editor, or editorial board of The Journal of Nutrition. The Guest Editors for the symposium publication are Adam Drewnowski, University of Washington, Seattle, WA, and Barbara Rolls, The Pennsylvania State University, University Park, PA.

	LITERATURE CITED

TOP LITERATURE CITED

 

1. Hill, J. O., Sallis, J. F. & Peters, J. C. (2004) Economic analysis of eating and physical activity: a next step for research and policy change. Am. J. Prev. Med. 23(suppl. 3):111-116.

2. Drewnowski, A. (2004) Obesity and the food environment: dietary energy density and diet costs. Am. J. Prev. Med. 23(suppl. 3):154-162.

3. Sturm, R. (2004) The economics of physical activity: societal trends and rationales for intervention. Am. J. Prev. Med. 23(suppl. 3):126-135.

4. Critser, G. (2003) Fat Land 2003 Houghton Mifflin New York, NY.

5. Nestle, M. (2002) Food Politics 2002 University of California Press Berkeley and Los Angeles, CA.

6. French, S. A., Story, M. & Jeffery, R. W. (2001) Environmental influences on eating and physical activity. Ann. Rev. Public Health 22:309-325.[Medline]

7. Brownell, K. D. & Horgen, K. B. (2004) Food Fight 2004 McGraw-Hill New York, NY.

8. Ledikwe, J. H., Ello-Martin, J. A. & Rolls, B. J. (2005) Portion sizes and the obesity epidemic. J. Nutr. 135:905-909.[Abstract/Free Full Text]

9. Drewnowski, A. & Darmon, N. (2005) Food choices and diet costs: an economic analysis. J. Nutr. 135:900-904.[Abstract/Free Full Text]

10. French, S. A. (2005) Public health strategies for dietary change: schools and workplaces. J. Nutr. 135:910-912.[Abstract/Free Full Text]

11. Kennedy, E. T. (2005) The global face of nutrition: what can governments and industry do?. J. Nutr. 135:913-915.[Abstract/Free Full Text]

12. Swinburn, B. A., Caterson, I., Seidell, J. C. & James, W.P.T. (2004) Diet, nutrition and the prevention of excess weight gain and obesity. Publ. Health Nutr. 7:123-146.

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