Outlook: Obesity

SEPTEMBER 18, 2011

Fork Size Affects Amount of Food Consumed
Individuals who use a larger fork and take bigger bites may end up eating less at restaurants, according to research published in the June issue of the Journal of Consumer Research.

A team of investigators led by Arul Mishra, PhD, of the University of Utah, set out to examine the influence of small versus large bite sizes on overall quantity of food consumed by randomly selecting tables at a local Italian restaurant to receive forks that were either 20% larger or 20% smaller than the forks normally used. To calculate how much food each person had eaten, researchers weighed each plate of food before it was served and again when it came back.

Results of the 2-day study showed that overall, individuals who were given bigger forks ate less food, leading the investigators to question the role that visual cues can play in consumption, particularly given the fact that individuals tend to eat more when they are given bigger portions, but less when they are given bigger forks.

They concluded that when using a smaller fork, diners don’t feel that they are making much of a dent in consuming their food and satisfying their hunger. “This, in turn, focuses diners to put in more effort toward satiating their hunger. As a result, diners with smaller forks consume more food than those using larger forks,” the authors wrote.

Mishra and colleagues concluded that a better understanding of hunger cues is critical to help avoid overeating.

Proximity to Fast Food Restaurants Linked to Poor Diet
Living near fast-food restaurants appears to be linked to an individual’s consumption of these foods, whereas living near grocery stores and supermarkets seems generally unrelated to dietary quality, according to data published in the July issue of Archives of Internal Medicine.

The federal government has made it a priority to reduce “food deserts”—areas in which healthy food is difficult to find, with the logic being that “reduced access to fast food and increased access to supermarkets will translate into improvements in diet behavior and health,” the article stated.

A team of researchers from the University of North Carolina at Chapel Hill assessed this assumption using data collected from a large-scale study over a 16-year period. The authors evaluated fast food consumption, diet quality, and adherence to fruit-and-vegetable-consumption guidelines as a function of fast food chain, supermarket or grocery store availability within distances of less than 1 to more than 8 km from study participants’ homes.

A link between fast food consumption and fast food availability was observed in participants at lower income levels; particularly in men who had access to fast food between 1 and 3 km from their home. The findings did not, however, suggest strong relationships between supermarkets and diet quality.

“Our findings suggest that no single approach, such as just having access to fresh fruits and veggies, might be effective in changing the way people eat,” said Penny Gordon-Larsen, PhD, the study’s senior author. “We really need to look at numerous ways of changing diet behaviors.”

Bariatric Surgery Makes Financial Sense for All Obese Patients
Bariatric surgery is not only cost-effective for treating people who are severely obese, but also for those who are mildly obese, according to a study published in the July issue of Maturitas.

Individuals who undergo the surgery are more likely to keep weight off over time and have fewer medical problems related to their weight, which results in fewer health-related costs down the road, the investigators found.

“If lifetime medical costs are taken into consideration, surgery saves severely obese patients money,” said lead author Su-Hsin Chang, PhD, of Washington University School of Medicine in St. Louis.

Chang and her colleagues analyzed data from 170 studies looking at the effectiveness of bariatric surgery by estimating and simulating the life expectancies and quality of life of individuals who underwent surgery versus those who did not.

They found that for patients with a BMI of 50 or greater, the cost per quality-adjusted life year (QALY) is negative, meaning that over a lifetime, the cost of surgery is less than the healthcare costs associated with not having the procedure. For the severely obese (BMI of 40-50), the cost per QALY is about $1,900 for those with obesity-related disease and about $3,800 for those who are otherwise healthy. And for the moderately obese (BMI of 35-40), the cost per QALY is about $2,400 for those with related medical problems and $3,900 for those who are healthy.

“Based on our analysis, bariatric surgery should be an option that is universally available to all obese people,” said Chang.