Received: 15 February 2022 Revised: 25 July 2022 Accepted: 18 September 2022

DOI: 10.1111/jtxs.12724

RESEARCH ARTICLE

Effect of food portion on masticatory parameters in 8- to

10-year-old children

mez-Zúñiga 1
Roberto S. Go | Ana Wintergerst 1,2

1
Graduate School of Dentistry, Universidad
Nacional Auto
noma de México, México City, Abstract
Mexico
The objective of this study was to explore differences in bite size and the amount of
2
Facultad de Estudios Superiores Zaragoza,
Universidad Nacional Auto
noma de México, intraoral processing of four different foods between a reference and a double portion
México City, Mexico in 8- to 10-year-old children and, also to explore if there were differences depending

Correspondence
on the child's weight status. The study was undertaken in 8- to 10-year-old children

n de Estudios de
Ana Wintergerst, Divisio (n = 89). Body mass index was determined, and weight status was established based

n, Facultad de
Posgrado e Investigacio
Odontología, Universidad Nacional Auto
noma on Centers for Disease Control and Prevention(CDC) guidelines. A reference (half a
de México, Av. Universidad, 3000, Ciudad de banana, half a large peeled carrot, a slice of loaf cake, and half a salami stick), and a
Mexico C.P. 04510, Mexico.
Email: anawintergerst@yahoo.com
double portion of each food were offered to children in a randomized order in two
different sessions. Three consecutive bites were taken and averaged. Variables in this
Funding information
Programa de Apoyo a Proyectos de
study were bite size (g), number of cycles until swallowing, sequence duration as well

n e Innovacio
Investigacio
n Tecnolo

gica as cycles/g. Comparisons were performed with Mann–Whitney, Kruskal–Wallis, and

noma de
(PAPIIT), Universidad Nacional Auto
México, Grant/Award Number: IN-231320 Wilcoxon tests, regressions and correlations were run. Bite size was ≈13% larger
with the double portion (p ≤ .05 for salami, banana, and loaf cake). Cycles/g
decreased for all foods with the double portion, although only significantly for
banana and loaf cake. Normal and obese children had larger bite sizes (p ≤ .05) of
banana than overweight children, while only obese had larger bites of loaf cake with
the double portion. In conclusion, the bite size of foods in 8- to 10-year-old children
increases (13%) when the portion size is doubled and the larger bite size leads to
fewer cycles/g (8%). These effects differ among foods. These parameters do not
depend on weight status.

KEYWORDS
bite size, children, mastication, masticatory parameters, obesity, portion size effect

1 | I N T RO DU CT I O N
The portion size effect corresponds to a larger intake when food por-
tions increase; it is observed across different food types, environmen-
tal conditions, and study populations (English, Lasschuijt, &
This article was published on AA publication on: 22 September 2022.
Keller, 2015). This effect has been studied since portion sizes of many
individual foods and meals have increased over the years (Piernas &
Popkin, 2011; Steenhuis, Leeuwis, & Vermeer, 2010).
When the portion size is doubled in adults, there is a 35%
increase in the amount of food consumed (Zlatevska, Dubelaar, &
Holden, 2014) and consequently energy intake rises (Steenhuis &
Poelman, 2017). This effect has also been reported in children (Fisher,

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J Texture Stud. 2023;54:67–75. wileyonlinelibrary.com/journal/jtxs 67

68
Rolls, & Birch, 2003; Rolls, Engell, & Birch, 2000). Fisher, Liu, Birch,
and Rolls (2007) reported that the total consumption of a child
increases with a larger portion size; energy intake increases as well
(Fisher et al., 2007; Mooreville et al., 2015). Some of the studies on
portion size effect have found that this effect is stronger in obese
adults (Hill & McCutcheon, 1984; Zijlstra et al., 2011) and obese chil-
dren (Smethers et al., 2019).
Obesity is a complex multifactorial disease, a serious global
health problem and an important cause of morbidity and mortality.
There is a high incidence of obesity among children (WHO, Global
Health Observatory data repository, n.d.). Among many factors
influencing weight status, there are: food sources and the quality
of nutrients, frequent snack eating, ample screen time, less physi-
cal activity, an incorrect parental perception of the child's weight
status, social, behavioral, or psychological factors, birth weight
and commercial advertising (Aljassim & Jradi, 2021; Lee &
Yoon, 2018; Parsons, Power, Logan, & Summerbell, 1999). It is
difficult to sort out the relationships between potential factors.
Genetic factors are also known to play a role in determining an
individual's predisposition to being obese (Lin & Li, 2021; Singh,
Kumar, & Mahalingam, 2017); however, children may also
“inherit” parental dietary behaviors and food practices (Larsen
et al., 2015).
The mechanisms of the portion size effect are not clear (English
et al., 2015). Some of the possible drivers that have been suggested
are visual cues, anchoring and adjustment, learning, and reward, as
well as previous experiences/expectations (English et al., 2015;
Steenhuis & Poelman, 2017). One of the facets of the portion size
effect that has received little attention is the relationship between
variations in food portion size and intraoral processing (i.e., size of
the bites, number of chews needed to prepare food for swallowing,
and chews/g). The scarce information on the influence of portion
size on bite size has reported that when portion size is doubled in
adults, their bite size is larger (Burger, Fisher, & Johnson, 2011). In a
study that only included overweight women increasing the portion
size led not only to a larger bite size but also to a faster eating rate
(g/min) (Almiron-Roig et al., 2015). To the best of our knowledge,
information is practically nil in relation to the effect of a larger bite
size on intraoral processing in children. Two studies did not identify
differences in chewing cycles performed over 15 min with a larger
portion size (Fisher, 2007; Fisher et al., 2003). A recent study in chil-
dren chewing two different portions of an artificial test food
reported that food breakdown is less with a larger bolus size since

mez-
less chews per gram are performed (Wintergerst & Go
Zúñiga, 2022).
Because more information on bite size and to a greater extent on
other parameters of intraoral processing related to the portion size
effect are needed in children, the objective of this study was to
explore differences in bite size and amount of intraoral processing of
four different foods with a reference and a double portion in 8- to
10-year-old children and, also to explore if there were differences
depending on the child's weight status.
GÓMEZ-ZÚÑIGA AND WINTERGERST
2 | M A T E R I A L S A N D M ET H O D S
2.1 | Design and study participants
Bite size depending on the portion size was tested with a within-
subject crossover design, the comparison of the bite size based on
weight status was performed as a cross-sectional study. Participants
in the study were 8- to 10-year-old children from two primary schools
of the same socioeconomic level of the same city. Children were
excluded if they had any diagnosed systemic disease, dental pain,
large cavities or a very loose tooth, evident craniofacial abnormalities,
a severe malocclusion (such as a clear class III or a posterior crossbite),
behavioral problems that could complicate the testing procedure, an
allergy or a definitive aversion to any of the foods.
We performed convenience sampling; 84 children would allow
detecting an increase from 1.68 ± 0.82 (Wintergerst, Garza-Balles-
teros, & Garnica-Palazuelos, 2016) to 1.93 ± 0.8 g (15% increase) in a
bite of salami between the two portion sizes (80% power, alpha of
0.05, one-tailed paired t test) and aimed for 30 children per group to
detect a 0.65 effect size in bite size between nutrition groups (80%
power, alpha of 0.05) (G*Power 3.1) (Faul, Erdfelder, Lang, &
Buchner, 2007).
This study was conducted in conformity with the ethical guide-
lines of the World Medical Association Declaration of Helsinki and
was approved by the Ethics Committee of the affiliated institution of
the authors (CIE/0810/11/2018). Written informed consent was
obtained from all the parents before the study; children gave their
written and verbal assent.
2.2 | Test foods and portion sizes
The foods used for this study were banana (Tabasco), loaf cake
(Panque Marmoleado Bimbo), raw carrot, and a salami stick (Peperami
Zwan) (Figure 1). These foods were chosen because of their different
texture: two hard foods (carrot and salami) and two soft ones (banana
and loaf cake). These foods are eaten as a snack, for lunch or during a
full meal. The data on the bite size was obtained over two different
sessions, 1 week apart, with portion size (“reference” vs. “double”)
randomized (Dado, Atheris Apps). When an odd number, the portion
size was “reference” (half a banana, 54.1 ± 10.9 g; half a large peeled
carrot, 36.5 ± 10.1 g; a slice of loaf cake, 31.5 ± 4.0; and half a salami
stick, 10.5 ± 0.9 g). When the number was paired, the portion size
was “double” (a whole banana, 105 ± 13.1 g; a large peeled carrot,
67.0 ± 16.0 g; two slices of cake, 65.4 ± 6.0 g; and a complete salami
stick, 20.5 ± 1.4 g). The order of the foods was set as salty foods first
and then sweet ones since this is the way food is generally offered in
a meal, but the order of the foods was randomized. When an odd
number the order was carrot, salami, banana, and cake; when an even
number the order was salami, carrot, cake, and banana. Portion sizes
were determined based on the results of a prior study in 8- to
10-year-old children (Wintergerst et al., 2016). In this study, we define
GÓMEZ-ZÚÑIGA AND WINTERGERST
F I G U R E 1 Test foods in the study. The reference portion
consisted of half a carrot, half a salami stick, half a banana, and a slice
of loaf cake
portion size as the amount of food offered to the children (Fisher,
Goran, Rowe, & Hetherington, 2015).
2.3 | Experimental procedure
Sessions were undertaken between 1 and 3 hr after either breakfast
or lunch to avoid a possible hunger effect. The project was pre-
sented to parents of 412 eight- to ten-year-old children during par-
ent/teacher meetings; 318 of them agreed to their child's
participation and signed the informed consent forms. Since parents
had given their informed consent in a parent-teacher meeting, we
first verified that the children met the selection criteria. After
screening for selection criteria, only 91 children were included. Chil-
dren then watched a 79-s video of a girl explaining the experimental
procedure so that they would feel comfortable and understand the
procedure. If they gave their assent, children were weighed with
light clothing using a portable electronic scale (Tanita, BF-689) to
the nearest 0.1 kg. Height was measured with a tape attached to the
wall while children were standing straight, looking forward with their
backs to the wall, with no shoes and heels touching the wall. These
parameters were used to determine body mass index (BMI) [body
weight (kg)/height squared (m2)]. Children's weight status was deter-
mined according to the Centers for Disease Control and Prevention
(CDC) guidelines (Kuczmarski et al., 2002): obese (≥95th percentile),
overweight (85th–94th percentile), and normal weight (5th–84th
percentile).
Before starting the experimental procedure, children cleaned their
hands with alcohol gel for 60 s. Children were seated on a chair with
no head support and in front of a table. The experimental procedure
consisted in children taking the food placed on a plate on top of a
scale (BEB, 120 g  0.001 g, BOECO, Germany). The initial weight
69
was registered and after the child took a bite (no specific instructions
on the bite), they would then return the food to the plate and the new
weight was registered. The subtraction of the weights was used as
the bite size. Children were asked to chew normally when instructed
to start and to lift their hand at the moment they had swallowed the
food completely. The sequence was filmed with a cell phone (iPhone
11 Pro). Bite size (for each food and portion size) was determined as
the average of three consecutive bites. Children could rest between
repetitions if they requested to when asked. The testing time lasted
approximately 10 min per session. At the end of the session, the unea-
ten portions of food for each child were placed in a bag with the name
of the child and given to their teachers so they could give it to them
at the end of the school day.
The first author was standardized by the second author in the
counting of the chewing cycles with natural foods. Reliability between
and within researchers was established over 15 chewing sequences
with each test food (intraclass correlation coefficients, two-way mixed
effect model, absolute agreement, means of raters). There was excel-
lent between subject reliability for carrot, salami, and banana
(.960–.998) and good reliability with cake (.858); within-subject reli-
ability was excellent (.972–.998). A chewing cycle is described as a
cycle with an opening and closing phase as in typical cycles eliminat-
ing those clearly used to only shift or conform the bolus (e.g., long
cycles with the tongue pressing the cheeks or lips; 0–2 cycles per
sequence).
To determine the number of cycles required by the children
before swallowing as well as sequence duration, the videos were
downloaded to a computer. Software VLC media player (VideoLAN,
version 3.0.11) at a reproduction speed of 0.50 was used to analyze
and count the number of cycles. Sequence duration was determined
by running the video at a normal speed. The number of cycles/g of
the test food was determined by dividing the number of chews by the
child's average bite size of each test food.
2.4 | Statistical analysis
Data was captured in an Excel sheet and later analyzed using IBM
SPSS Statistics for Windows, version 28 (IBM Corp., Armonk, NY).
Descriptive statistical procedures were performed. Data distribution
was assessed by inspecting skewness and kurtosis. BMI was normally
distributed, but the other variables were not consistently normally dis-
tributed for all food, portion size, or weight status. Data are expressed
as mean ± SD or as the median and interquartile range (IQR) of three
repetitions. Data were compared (portion sizes, weight status) using
nonparametric tests (Wilcoxon signed-rank tests, Kruskal–Wallis, or
Mann–Whitney tests). Spearman correlations between BMI and bite
sizes as well as with cycles/g were assessed, and linear regression
models were tested (with BMI as an independent variable (I.V) and
bolus size/ reference and double portions, as well as cycles/g as
dependent variables (D.V.), with bolus size with the reference portion
as the I.V. and bolus size with the double portion as the D.V., and with
bite size of each food as the I.V. and cycles/g as the D.V.). Statistical
significance was set at p ≤ .05.
70 GÓMEZ-ZÚÑIGA AND WINTERGERST

3 | RESULTS
Characteristics of the study groups are found in Table 1. Medians for
the reference and double portions for bite size, sequence duration,
number of cycles needed to reach swallowing threshold, and cycles/g
are presented in Tables 2–5. Bite size was larger with the double por-
tion for all foods although the difference was statistically significant
for salami, banana, and loaf cake (15%, 20%, and 9%, respectively)
(Table 2). Sequence duration was only longer for banana (1%)
(Table 3). Cycles/g decreased for all foods, but the difference was only
statistically significant for banana and loaf cake (10% and 9%, respec-
tively) (Table 5). The values for the different nutritional groups for the
different variables tested are also presented in Tables 2–5. Normal
and obese children had statistically larger bite sizes of banana with
the double portion (14% and 40%, respectively), while only obese chil-
dren had significantly larger bite sizes with loaf cake (24%) (Table 2).
Only obese children had significantly longer sequence durations with
salami stick and banana (22% and 8%, respectively) as well as less
cycles/g with banana (31%) (Tables 3 and 5). Obese children had less
cycles/g with the double portion of loaf cake than the normal and
overweight children (Table 5). Differences between the reference and
the double portions were also compared between the nutritional
groups (data not shown); there was only a significant difference for
bite size with banana in obese children (3.95 g IQR 6.3 vs. 1.3 g IQR
6.2, p = .023, and .61 g IQR 2.7, p = .004, Mann–Whitney, normal,
and overweight, respectively).
Correlations between BMI and bite size and cycles/g with both
food portions were not significant except for bite size with the refer-
ence portion of banana ( .240). Linear regressions with bite size with
the double portion as the dependent variable are presented in
Table 6. Variance explained by the small portion increases from carrot,
to salami stick, to banana and is highest with loaf cake (53%). The
regressions with bite size of each food as the independent variable
and cycles/g as the dependent variable were all significant and only
slightly higher for the double portion than with the reference portion,
but the variance explained was less than 30% for all foods (data not
shown). Linear regressions indicate that the variance in bite sizes with
the two portion sizes cannot be explained by BMI (data not shown).
4 | DI SCU SSION
The results of this study indicate that portion size influences bite size
in 8- to 10-year-old children and that the 13% larger bite size with a

T A B L E 1 Sample population by sex

Nutritional status group based on body mass index (mean ± SD)
and nutritional status based on their
Normal weight (16.29 ± 1.39) Overweight (19.11 ± 1.32) Obese (22.25 ± 2.42) body mass index
Boys 17 11 21
Girls 17 10 13

TABLE 2 Medians and interquartile ranges (in parenthesis) for bite size for the different foods for the reference and double portions

Food Group Reference Double p=

Carrot Overall 4.65 (3.51) 5.04 (3.71) .309
Normal 4.74 (3.67) 5.17 (3.65) .521
Overweight 4.02 (3.37) 3.86 (3.86) .768
Obese 4.58 (3.51) 5.14 (4.14) .235
Salami stick Overall 1.78 (1.24) 2.04 (1.70) .037
Normal 1.95 (1.27) 2.11 (1.52) .209
Overweight 4.02 (3.37) 3.86 (3.86) .259
Obese 1.60 (0.01) 1.99 (1.88) .228
Banana Overall 10.439 (5.68) 12.532 (9.00) <.001
Normal 11.65 (6.27) 13.27 (9.06) .033
Overweight 10.00 (7.02) 11.05 (4.19) .274
Obese 9.69 (4.68) 13.27 (10.72) <.001
Loaf cake Overall 4.532 (2.42) 4.924 (2.92) .004
Normal 4.62 (1.97) 4.94 (3.00) .191
Overweight 4.53 (2.54) 4.60 (2.41) .205
Obese 4.16 (2.33) 5.15 (3.66) .017

Note: Bite size is expressed in grams. Values with statistical differences between the reference and double portion (Mann–Whitney) are in bold. When
comparing each variable between nutritional groups, for example, bite size with the reference portion between normal, overweight, and obese, no
statistical differences were found.
GÓMEZ-ZÚÑIGA AND WINTERGERST 71

T A B L E 3 Medians and interquartile ranges (in parenthesis) for double portion of food leads to less intraoral processing (i.e., fewer
sequence duration for the different foods for the reference and cycles/g). Contrary to what was expected bite size did not vary
double portions
consistently between children of different weight status.
Food Group Reference Double p= Different factors affect bite size. The type of food is one of these
Carrot Overall 23.38 (20.06) 25.57 (18.04) .191 factors; in the current study bite size was different for all foods. Bite
Normal 24.38 (23.62) 25.72 (15.76) .817 size was largest for banana followed by carrot; Hiiemae et al. (1996)

Overweight 22.78 (10.85) 23.06 (14.40) .543 found a larger bite size for banana, than for apple or biscuit in adults.
The correlations found between bite size with the reference and dou-
Obese 22.95 (21.07) 29.77 (20.24) .118
ble portion reveal that children with larger bites with the reference
Salami stick Overall 23.97 (13.90) 24.88 (15.20) .069
portion also gave larger bites with the double portion. The weight of
Normal 25.50 (16.25) 25.75 (13.49) .533
the bite of each food with the reference portion explains variance
Overweight 23.54 (10.36) 22.50 (8.95) .958
with the double portion. For example, for each gram of the loaf cake
Obese 20.88 (15.17) 25.51 (19.73) .041
with the reference portion, bite size with the double portion increased
Banana Overall 10.51 (4.59) 10.66 (6.45) .019
by 0.81 g (r2 = .53). Bite size of three of the four test foods increased
Normal 9.60 (3.38) 9.46 (8.12) .804 with the larger portion size. This increase was largest for banana and
Overweight 10.71 (4.66) 9.83 (3.17) .848 not statistically significant for carrot, perhaps due to its texture or pal-
Obese 10.70 (6.04) 11.59 (8.34) .001 atability. This result coincides with a study in which when larger por-
Loaf cake Overall 14.75 (9.30) 14.88 (7.61) .487 tions were served to children, they ate greater amounts of all food
Normal 14.60 (10.14) 14.70 (9.36) .765 types except vegetables (Smethers et al., 2019) and another study
Overweight 14.87 (7.85) 13.63 (6.74) .931 where 5- to 6-year-old children were offered the same amount of

Obese 15.04 (11.10) 15.32 (8.33) .228 pasta with a normal or double amount of applesauce, broccoli or car-
rot as side dishes; the intake of the fruit side dish increased but not of
Note: Sequence duration is expressed in seconds. Values with statistical
the vegetable side dishes (Kral, Kabay, Roe, & Rolls, 2010). Children
differences between the reference and double portion (Mann–Whitney)
are in bold. When comparing each variable between nutritional groups, for often link vegetables to negative sensory experiences, and they prefer
example, sequence duration with the reference portion between normal, the taste of fruit or junk food to vegetables (Krølner et al., 2011).
overweight, and obese, no statistical differences were found. The average increase in bite size for all four foods was 13%. This
increase is similar to the results of the few studies available in children,
although they tested with a soft composite food item. In 3- to 5-year-
T A B L E 4 Medians and interquartile ranges (in parenthesis) for old children, Fisher et al. (2003) reported that the bite size of macaroni
cycles needed to reach swallowing threshold for the different foods and cheese when given in a reference and double portion increased by
for the reference and double portions
12% with the double portion. Fisher (2007) evaluated bite size in 2- to
Food Group Reference Double p= -9 years olds with the same setup and foods and found that bite size
Carrot Overall 31.33 (26.33) 33.33 (22.67) .525 was 22% larger overall with the double portion of the entrée, although
Normal 33.67 (25.25) 33.67 (21.67) .959 the effect was smaller in the 8- to 9-year-old children.

Overweight 32.33 (16.17) 29.33 (13.33) .715 This trend is similar in adults. Bite size of obese women was eval-
uated with different portion sizes of chili-con-carne sauce with rice.
Obese 30.33 (27.75) 37.17 (30.17) .322
The finding was that for every 100 g increase in the portion, bite size
Salami stick Overall 28.67 (20.67) 30.33 (16.00) .180
increased by 10%; although in that study, subjects were asked to fin-
Normal 33.83 (20.33) 31.50 (13.49) .811
ish all the food on the plate (Almiron-Roig et al., 2015). Another study
Overweight 26.67 (17.33) 28.00 (15.00) .543
in adults eating a reference and a double portion of pasta reported
Obese 26.33 (23.00) 26.67 (24.92) .142
that bite size increased ≈18% with the double portion (Burger
Banana Overall 9.00 (6.00) 9.33 (6.00) .306 et al., 2011). Among the possible explanations that have been pro-
Normal 9.50 (6.17) 10.17 (7.17) .647 posed for the so-called portion-size effect are visual cues (English
Overweight 8.87 (5.17) 7.67 (3.50) .673 et al., 2015). In this study, adults were evaluated with both portion
Obese 9.00 (6.83) 9.67 (5.67) .303 sizes under two conditions: seeing the food and blindfolded; unex-
Loaf cake Overall 14.00 (8.33) 13.67 (7.00) .911 pectedly, bite size increased with the larger portion sizes in both test
Normal 15.00 (10.67) 15.00 (9.58) .578 conditions.
Overweight 14.00 (8.17) 12.67 (4.67) .945 The fundamental cause of obesity and overweight is an energy

Obese 13.17 (7.92) 13.33 (8.50) .607 imbalance between the calories consumed and those expended
(WHO, 2021), thus the interest in studying a possible association
Note: When comparing each variable between nutritional groups, for
between portions, bite sizes, and energy intake. When portion size is
example, number of cycles to reach swallowing threshold with the
reference portion between normal, overweight, and obese, no statistical doubled, the amount that children consume increases by 20% on
differences were found. average (Zlatevska et al., 2014). While total energy intake increases
72 GÓMEZ-ZÚÑIGA AND WINTERGERST

TABLE 5 Medians and interquartile ranges (in parenthesis) for cycles/g for the different foods for the reference and double portions

Food Group Reference Double p=

Carrot Overall 7.18 (3.34) 6.74 (3.41) .367
Normal 7.78 (3.48) 6.94 (2.54) .242
Overweight 7.21 (3.11) 7.09 (3.71) .958
Obese 6.88 (4.53) 6.46 (5.09) .765
Salami stick Overall 15.94 (8.94) 14.59 (8.60) .629
Normal 16.69 (11.04) 14.50 (6.55) .457
Overweight 14.73 (9.49) 14.59 (7.79) .520
Obese 14.91 (6.60) 14.29 (11.32) .808
Banana Overall 0.80 (0.52) 0.72 (0.53) .004
Normal 0.78 (0.49) 0.79 (0.42) .144
Overweight 0.88 (0.57) 0.72 (0.57) .434
Obese 0.91 (0.73) 0.63 (0.64) .007
Loaf cake Overall 3.39 (1.89) 3.07 (1.60) .049
Normal 3.45 (1.49) 3.44 (1.81) .614
Overweight 3.26 (2.15) 3.04 (1.06) .205
Obese 2.91 (2.23) 2.45 (1.36) .108
Differences between groups Kruskal–Wallis, p = .050; Mann–Whitney, p = .025 normal vs. obese

Note: Values with statistical differences between the reference and double portion (Mann–Whitney) are in bold. When comparing each variable between
nutritional groups, the only differences found between the reference and double portion were for banana.

TABLE 6 Linear regressions with the bite size with the double portion as the dependent variable

Dependent variable Independent variable Gradient Intercept R2 Pearson's r p≤

Carrot Bite double portion Bite reference portion .519 2.745 .203 .451 .001
Salami Bite double portion Bite reference portion .763 0.716 .321 .567 .001
Banana Bite double portion Bite reference portion .766 5.283 .352 .593 .001
Loaf cake Bite double portion Bite reference portion .810 1.428 .529 .727 .001

with increased portion sizes, it does so mainly because of high energy
dense food, and weight status does not appear to drive this effect
(Mooreville et al., 2015). Most studies evaluate the portion size effect
basically over a single meal, but in a study including all meals over
5 consecutive days in a childcare setting, Smethers et al. (2019) identi-
fied that children's body size is positively related to consumption of
larger portions, even after energy needs are taken into account. The
increased energy intake from the larger portions persisted over the
entire 5-day period and the increase was mainly due to a higher con-
sumption of high energy density foods and less low energy dense
foods. In our study, bite size increased more with the high than with
the low energy dense foods.
Very few studies have evaluated the relationship between bite
size and children's nutritional status consequently the effect of a
larger bite size in obese children is unclear. We sought to analyze if
heavier children have larger bite sizes or if they are more susceptible
to the portion size effect. We did not find differences in bite size for
any of the foods between the three weight groups and the linear
regressions indicate that the variance in bite sizes with the two por-
tion sizes cannot be explained by BMI. Fisher et al.'s (2003) study
reported a tendency toward preschool children with a higher BMI to
have larger bite sizes regardless of the portion size but they did not
find the same effect in their 2007 study using the same test food in 2-
to 9-year-old children. In a study that included 4-year-old children sta-
tistically significant differences in bite size (1.8 vs. 2.2 g, p = .002)
were found between normal and overweight children (Fogel
et al., 2017). However, the testing procedure they used was different
since they included 9 foods in a buffet with children serving them-
selves freely; they counted the bites over the whole meal giving them
a better opportunity to detect a difference, which we could not iden-
tify with specific food items and only 3 bites.
The relationship between bite size and nutritional status is also
unclear in adults; some studies have not found an influence of weight
status on bite size (Burger et al., 2011; Spiegel, 2000), while others
have (Hill & McCutcheon, 1984; Zijlstra et al., 2011). Mattfeld, Muth,
and Hoover (2017) reported an increase of 0.20 g in bite size per BMI
point increase in a cafeteria setting with adults freely selecting the
amount and type of food from more than 300 different foods.
We did not find the expected differences in sequence duration or
number of cycles to reach the swallowing threshold between the
GÓMEZ-ZÚÑIGA AND WINTERGERST
reference and double portions or among the different nutritional sta-
tus children. Differences were found in these parameters when these
same children were tested chewing two different bolus sizes of an
artificial test food but the increase in bolus size was larger (25%
instead of 13%) although likewise, no differences were found for
these two variables among the nutritional groups (Wintergerst &

mez-Zúñiga, 2022).
Go
The reasons suggested for the portion size effect are many
(Steenhuis & Poelman, 2017; Zuraikat, Smethers, & Rolls, 2019). One
possibility is that we assume that the food on the plate is what we are
expected to eat or should eat (appropriateness mechanism according
to Steenhuis & Poelman, 2017), especially as children. Food-related
parenting practices definitively influence the way children eat
(Laessle, Uhl, & Lindel, 2001; Loth, 2016). An evolutionary theory indi-
cates that one should eat when food is available (Kersbergen, German,
Westgarth, & Robinson, 2019). If we assume that we should enhance
intake when there is more food available, a strategy to try to finish
the food probably over the same time period could be to increase bite
size and try to finish the food eating faster, which would necessarily
have an effect of reducing oral processing. This speculation would go
along with our findings: a larger bite size with children performing less
chews per gram with the double portion size, although the difference
was only significant for banana and loaf cake. In relation to chews/g,
the smaller the ratio, the greater the rate at which food is delivered as
a source of metabolic energy to the gastrointestinal tract (Lucas &
Luke, 1984). Two studies in children reported no differences in bite
frequency (chews during 15 min) between the reference and the dou-
ble portion sizes (Fisher, 2007; Fisher et al., 2003). A study in adults,
did find that portion size and eating rate (g/min) were positively corre-
lated (Almiron-Roig et al., 2015), indicating that oral processing time
per amount eaten is reduced as in our study. It is important to men-
tion that when these same children chewed on two different portions
of an artificial test food, chews/g decreased as the bolus size
increased and the effect of less cycles/g lead to a larger particle size

mez-Zúñiga, 2022).
at the moment of swallowing (Wintergerst & Go
Therefore, although we did not evaluate the median particle size of
the chewed food at swallowing threshold, we can assume that the
median particle size was larger with the double portion because there
were less chews/g for all foods with the double portions and this
effect was present for all nutritional groups.
A fast-eating rate is significantly associated with greater risk of
being overweight in children (Garcidueñas-Fimbres, Paz-Graniel, Nishi,

, & Babio, 2021) and is associated with increased adipos-
Salas-Salvado
ity in adolescents (Fagerberg et al., 2021). Fogel et al. (2020) reported
that the association between risk factors for obesity and adiposity at
6 years of age was moderated by eating behaviors such as bite size
and eating rate and in their 2017 study they identified that
overweight children ate faster (g/min). We did not find that obese
children eat faster, although when we compared the differences in
cycles/g for the reference and double portions for the three nutri-
tional groups, we identified that cycles/g were slightly less for the
obese than for the overweight and normal weight children. Thus, the
delivery of each gram of food with its potential metabolic energy to
73
the gastrointestinal tract is faster for these children than for normal
weight children (e.g., cycles/g for cake with the double portion). It was
interesting to find that under careful inspection there are more signifi-
cant differences for the obese children which were not seen in the
other nutritional groups, this leads us to think that there are differ-
ences in the way obese children eat, but we were not able to detect
important differences with our study design. In adults, it has been
reported that as obesity increases, bite size and eating rate increase
(amount/second), although body size is also an important contributor
(Hill & McCutcheon, 1984). On the contrary, White et al. (2015)
matched overweight or obese (adults) with normal BMI participants
and based on EMG activity chewing rate did not differ between high
and normal BMI participants while eating two rice and one pizza
meals. The rheology and palatability of the food items used in differ-
ent studies definitively influence study results.
We acknowledge the limitations for the current study. The most
important one may be that we only studied three consecutive bites
for each child under standardized conditions. Other studies have eval-
uated the portion size effect over a whole meal with mixed or amor-
phous foods, or over several meals, although this allowed us to have
data for each individual food. The study was performed at a school,
and despite not a home environment, children habitually eat their
lunch at school so we considered that the setting was more appropri-
ate than if the study would have been performed in a laboratory.
Overweight and obesity are among the main factors that contrib-
ute to non-communicable diseases. Because larger portion sizes lead
to more daily total energy intake in children (Fisher et al., 2015), the
development of healthy food portion sizes is considered to be central
to obesity prevention in childhood (WHO Technical Staff, 2014). It is
surprising that there is scarce research relating the microstructure of
eating to the portion size effect, particularly bite size, chewing rate,
and amount of intraoral processing in children. Consequently,
although complex, there is a need for further research in this area with
many factors to consider such as rheology, palatability, energy dense-
ness, and so forth, without neglecting the important role that market-
ing and parents play in establishing portion norms early in children's
lives.
5 | CONC LU SIONS
The bite size of food for 8- to 10-year-old children increases 13%
when the portion size is doubled. The results of this study contribute
valuable information on the portion size effect on cycles/g, which is
an important variable for the microstructure of eating. The 13% larger
bite size leads to 8% fewer cycles per gram which indicate less
intraoral processing. These effects differ among carrot, salami stick,
banana, and loaf cake. Bite size and oral processing did not vary con-
sistently among children of different weight status; larger sample
sizes or different methodologies might be needed to further explore
if they are truly not different in obese children. Further research is
needed in relation to the portion size effect and intraoral processing
in children.
74
AUTHOR CONTRIBUTIONS

mez-Zúñiga: Data curation (equal); formal analysis
Roberto S. Go
(equal); software (equal); writing – review and editing (supporting).
Ana Wintergerst: Conceptualization (lead); data curation (equal); for-
mal analysis (equal); funding acquisition (lead); project administration
(lead); software (equal); writing – original draft (lead); writing – review
and editing (lead).
ACKNOWLEDGMENTS
This study was supported by a grant (IN-231320) from Programa de

n e Innovacio
Apoyo a Proyectos de Investigacio
n Tecnolo

gica

noma de México. The authors
(PAPIIT), Universidad Nacional Auto
would like to acknowledge the authorities, parents, and teachers of

mez-Zúñiga would like
the two schools that participated. Samuel Go
to thank CONACyT for the scholarship during his Master's program.
DATA AVAI LAB ILITY S TATEMENT
Data may be accessible upon a reasonable request.
ETHI CAL S TATEMENTS
Conflict of interest: The authors declare that they do not have any
conflict of interest.
Ethical Review: This study was reviewed and approved by the Ethics
Committee of the School of Dentistry (CIE/0810/11/2018).
Informed Consent: Written informed consent was obtained from all
the parents of the participants prior to the study; children gave their
written and verbal assent.
ORCID
Roberto S. G
omez-Zúñiga https://orcid.org/0000-0003-0023-8177
Ana Wintergerst https://orcid.org/0000-0002-4403-4726
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How to cite this article: Go
A. (2023). Effect of food portion on masticatory parameters in
8- to 10-year-old children. Journal of Texture Studies, 54(1),
67–75. https://doi.org/10.1111/jtxs.12724