Amid Obesity Epidemic, More Americans Than Ever Are Cleaning Their Plates, New Surveys Find
Americans Still Look for Quick Fixes; Ignore Importance of Total Calories in Weight Management

According to the new AICR report, 69 percent of Americans now say that when dining out at table service restaurants, they finish their entrees most of the time or all of the time, up 2 percent from 2000. The number of women who say they finish their entrees every time they eat out has doubled, from 9 percent to 18 percent. This concerns experts at AICR, who point to scientific studies tracking the steady growth of portions in restaurants and fast food outlets over the past 20 years.

Figures from the report, called "Awareness and Action: AICR Surveys on Portion Size, Nutrition and Cancer Risk," indicate that Americans have even adopted this passive approach to portions at home. Fully 30 percent of Americans now say they generally base the amount of food they eat on the amount they are served, up 4 percent from previous surveys. Nearly half - 42 percent - say they base the amount of food they eat on the amount they are used to eating, up 8 percent from 2000 figures.

These findings are particularly troubling in light of recent scientific studies cited in the AICR report, which show that individuals can and do unconsciously consume more calories - as much as 56 percent more - when served larger portions.

At a press conference coinciding with AICR's International Research Conference on Food, Nutrition and Cancer, AICR Vice-President Jeff Prince inveighed against the "portion passivity" revealed by the new figures. "In a country where 64 percent of us are overweight or obese, there is an alarming tendency to overlook the sheer amount of food we're eating," he said. "And becoming aware of the amount of food we consume is key to managing weight, despite the American tendency to look for 'quick fixes,'" he said.

Prince was referring to another set of figures from the new AICR report, which show that 78 percent of Americans still believe the specific kind of food they eat is more important for losing weight than the sheer amount of food they eat. Evidently, a spate of recent health messages about "portion distortion" have gone unheeded - the tendency to ignore the importance of total calorie intake is just as strong as it was three years ago.

"Chain Reaction" Leads to Increased Risk for Cancer
The cancer experts at AICR are concerned about a "chain reaction" of factors leading to increased cancer risk. Scientists have now documented the steady growth of U.S. portion sizes, and their contribution to the current obesity crisis. Overweight and obesity are significant risk factors for cancer, said Prince.

In fact, the AICR report cites a study published in the April 24 The New England Journal of Medicine which concluded that overweight and obesity account for 14 percent of all deaths from cancer in men and 20 percent of those in women.

Americans Flunk Portion Test
"We have to regain our sense of appropriate portion size, so we can better gauge our intake, " said Prince. "AICR gave the nation a test on serving sizes, and the nation flunked."

In one of the surveys, AICR asked Americans to estimate the standard USDA serving sizes for common foods like green beans, nuts, mashed potatoes and cereal. Survey respondents were given several possible amounts for each food, and asked to choose.

Out of eight questions, well over half of respondents (61 percent) missed four or more - a failing grade. Fully 7 percent were only able to answer one question correctly.

Prince was quick to add that USDA standard serving sizes are a unit of measure, not a recommended amount of food. He maintained, however, that Americans' fundamental lack of familiarity with such a basic nutritional concept is symptomatic of a large and potentially dangerous problem.

Some Good News in New Numbers
But there is also cause for hope in the AICR report. According to the surveys, awareness of the importance of portion size has increased slightly - but only among men. The number of men who say the amount of food is more important for weight management has jumped 8 points - from 14 percent to 22 percent - in three years. (Women, however, are 4 percent less likely to look to total calorie intake.)

Americans are also getting better at estimating portion sizes. In 2000, 76 percent of those surveyed failed the portion size test administered by AICR, 15 percent more than the number who failed this year's test. A whopping 31 percent of Americans in 2000 only got one question right, compared to 7 percent today.

Awareness of Obesity-Cancer Link on the Rise
Perhaps the most encouraging figure in the report, Prince said, dealt with Americans' beliefs regarding causes of cancer. When asked to identify significant risk factors for cancer, only 35 percent of Americans surveyed in 2001 recognized the role played by obesity and overweight. Other factors, including many with no proven link to cancer scored much higher, including pesticide residue on produce (72 percent), food additives (53 percent) and stress (48 percent).

By 2003, awareness of obesity as a risk factor had jumped 10 percentage points to 45 percent, the single largest change observed in the survey on cancer risk factors.

Awareness of Growing Restaurant Portions Increases…
Overall, Americans are slightly more likely (8 percent) than they were in 2000 to recognize that restaurant portions have grown, but the total number remains low (only 38 percent.)

…Yet Americans are Gobbling Up That Extra Restaurant Food
According to the report, 27 percent of Americans overall say that, when dining out at table-service restaurants, the finish their entrees all the time, up 7 percent from 2000.

Few Americans Acknowledge "Portion Creep" at Home …
Despite the fact that several studies have suggested that bigger portions are finding their way into American homes, only 1 in 5 say that they are eating larger amounts of food at home, and this number has held steady.

… But Passive Approach to Portions Suggests Otherwise
As noted above, 30 percent of Americans say the amount of food they consume depends on how much they are served, up 4 percent from 2000. Scientific studies show that people can and do unconsciously consume more calories - as much as 56 percent more - when served larger portions. Another 42 percent of Americans base the amount of food they eat on how much they are used to eating. But caloric needs decrease with age, and older individuals whose caloric consumption remains constant are likely to become overweight.

Survey on Beliefs about Cancer Risk Factors Show Americans Have Got it Backwards
When Americans are asked to identify significant risk factors for cancer, they remain content to blame cancer on unproven factors that are beyond their control:

• Radiation (79%)
• Pesticide Residue on Produce (66%)
• Nuclear Power (62%)
• Radon (54%)
• Food Additives (49%)

Awareness is generally much lower about the kind of lifestyle factors that are proven to increase cancer risk - factors that can be changed with simple, everyday changes.

• Insufficient Physical Activity (36%)
• Diets High in Red Meat (33%)
• Alcohol (38%)
• Diets Low in Fruits, Vegetables (42%)

The complete text of the AICR 2003 Awareness and Action Report is available at: www.aicr.org/press

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