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Abstract Background This study experimentally examined the effects of repeated exposure to different meal portion sizes on energy intake. Methods Nineteen employees of a county medical center were given free box lunches for two months, one month each of 1528 and 767 average kcal. Foods were identical in the two conditions, but differed in portion size. Meals averaged 44% calories from fat. Participants self-reported how much of each lunch was eaten. Unannounced 24-hour dietary recalls were also conducted by phone twice per week during each exposure period. Results Mean energy intake at the lunch meal was 332 kcal/day higher in large lunch than in small lunch periods (p < .001). Mean 24-hour energy intake was 278 kcal/day higher in large versus small lunch periods (p < .001). There was no evidence of compensation over time. Average weight change over the month of large and small lunches was 0.64 ± 1.16 kg and 0.06 ± 1.03 kg, respectively, about what would be expected with the observed differences in energy intake. Conclusion This study suggests that chronic exposure to large portion size meals can result in sustained increases in energy intake and may contribute to body weight increases over time.

Little is known about lay advice on prenatal alcohol and cigarette use and how this advice may complement or counteract advice from health professionals. In this study we examine the advice-giving role of female friends and relatives ("confidantes"). Survey data were collected from 105 low-income pregnant women about prenatal alcohol and cigarette use and confidante advice about these behaviors. Focus groups with 9 confidantes of pregnant smokers examined the advice they offered about substance use, their perceptions of these behaviors, and their roles as advice-givers. The rate of prenatal drinking was low among pregnant smokers, consistent with confidantes' high risk perceptions and zero tolerance for drinking, but low risk perceptions and high tolerance for smoking. Confidantes described barriers to providing advice about smoking cessation. Because confidantes perceived their role to be distinct from, and in some ways more influential than, that of doctors their advice should be considered in the development of prenatal substance use interventions. [ABSTRACT FROM AUTHOR]