***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVES : Dishware size is thought to influence eating behaviors , but effects on children ’s self-served portion sizes and intakes have not been studied . We aim ed to evaluate whether larger dishware increased children ’s  self-served portion sizes and intake during meals . METHODS : A within-subjects experimental design was used to test the effects of dishware size ( ie , plates and bowls ) on children 's self-served portion sizes and intakes in a naturalistic setting . Subjects were predominantly African American elementary school – aged children ( n = 42 ) observed on repeated occasions during school lunch . Children served themselves an entree and side dishes using either child- or adult-size dishware , which represented a 100 % increase in the surface area of plates and volume of bowls across conditions . Condition order was r and omly assigned and counterbalanced across 2 first- grade classrooms . Entrées of amorphous and unit form were evaluated on separate days . Fruit and vegetable side dishes were evaluated at each meal . Fixed portions of milk and bread were provided at each meal . RESULTS : Children served more energy ( mean = 90.1 kcal , SE = 29.4 kcal ) when using adult-size dishware . Adult-size dishware  promoted energy intake indirectly , where every additional calorie served result ed in a 0.43-kcal increase in total energy intakes at lunch ( t = 7.72 , P = .001 ) . CONCLUSIONS : Children served themselves more with larger plates and bowls and consumed nearly 50 % of the calories that they served . This provides new evidence that children ’s self-served portion sizes are influenced by size-related facets of their eating environments , which , in turn , may influence children ’s energy intake Background The increasing prevalence of obesity is a significant health threat and a major public health challenge . A critical need exists to develop and evaluate practical methods for the treatment of obesity in the clinical setting . One of the factors contributing to the obesity epidemic is food portion sizes . Limited data are available on the efficacy of visual or tactile devices design ed to enhance patient underst and ing and control of portion sizes . A portion control plate is a commercially-available product that can provide visual cues of portion size and potentially contribute to weight loss by enhancing portion size control among obese patients . This tool holds promise as a useful adjunct to dietary counseling . Our objective was to evaluate a portion control intervention including dietary counseling and a portion control plate to facilitate weight loss among obese patients in a primary care practice . Findings We r and omized 65 obese patients [ body mass index ( BMI ) ≥ 30 and < 40 ] to an intervention including counseling by a dietitian incorporating a portion control plate or to usual care . Following initial consultation , patients in the intervention arm were contacted at 1 , 3 , and 5 months by the dietician for brief follow-up counseling . Usual care subjects received instructional h and outs on diet and exercise .  Forty-two ( 65 % ) subjects returned to have weight assessed at 6 months . Subjects in the portion control intervention had a greater percentage change ( ± SD ) in weight from baseline at 3 months ( -2.4 % ± 3.7 % vs. -0.5 % ± 2.2 % ; p = 0.041 ) and a non significant trend in weight change from baseline at 6 months ( -2.1 % ± 3.8 % vs. -0.7 % ± 3.7 % ; p = 0.232 ) compared with usual care . Nearly one-half of patients assigned to the portion control intervention who completed the study reported the overall intervention was helpful and the majority would recommend it to others . Conclusions Our findings suggest that a portion control intervention incorporating dietary counseling and a portion control plate may be effective for enhancing weight loss among obese subjects . A portion control intervention deserves further evaluation as a weight control strategy in the primary care setting .Trial registration Current controlled trials The aim of the study was to determine whether plate size affects ad libitum energy intake ( EI ) at a buffet-style lunch in overweight , yet unrestrained women . Twenty overweight/obese ( BMI = 25 - 40 kg/m(2 ) ) women attended two study visits , and were r and omly assigned to small ( 19.5 cm ) or large ( 26.5 cm ) diameter plate size at a free choice lunch meal . At 9 am participants were given a small ( 0.5 MJ ) breakfast , followed at 12 noon by the lunch meal from which they ate ad lib until comfortably full . Mean ( SEM ) EI at lunch was 3975 (239)kJ and 3901 ( 249 ) kJ respectively for small and large plate size . There was no detectable difference in EI between the two plate sizes ( P>0.05 ) . When in a raised state of hunger and offered a palatable buffet meal , altering the diameter of the dining plate onto which food was self-served did not significantly alter ad lib EI . We conclude there was no evidence that a smaller plate suppressed EI in a group of unrestrained , overweight women encouraged to eat to appetite from a wide choice of items . Whether plate size is a useful cue for portion size , and hence control of EI , in individuals actively restricting intake however remains possible , and requires investigation BACKGROUND Portion size is an important determinant of energy intake . To our knowledge , no r and omized controlled trial has evaluated the efficacy of portion control tools to induce weight loss . In patients with type 2 diabetes mellitus , weight reduction improves glycemic control . METHODS We r and omly assigned 130 obese patients with type 2 diabetes mellitus ( including 55 patients taking insulin ) to the daily use of a commercially available portion control plate for 6 months ( intervention group ) vs to usual care in the form of dietary teaching ( usual care control group ) . RESULTS Follow-up was 93.8 % . Patients in the intervention group lost significantly more weight than control subjects ( mean+/-SD , 1.8%+/-3.9 % vs 0.1%+/-3.0 % , P=.006 ) . Compared with controls , more patients in the intervention group required a decrease in their diabetes medications at 6 months ( 26.2 % vs 10.8 % , P=.04 ) . CONCLUSIONS Compared with usual care , the portion control tool studied was effective in inducing weight loss . The portion control plate also enabled patients with diabetes mellitus to decrease their hypoglycemic medications without sacrificing glycemic control . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00254124 Objective : Because younger children lack the motor skills required to serve themselves without spilling , adults often ask children how much they would like to eat and then serve the requested amount onto bowls . Previous research shows that larger bowls biases adults towards serving themselves larger portions . We examine if larger bowls biases children towards requesting more food from the adults who serve them . Study Design : Study 1 was a between-subject design involving 69 pre-schoolers who were r and omized to receive either a small ( 8 oz ) or large ( 16 oz ) cereal bowl  and were asked to tell research ers how much cereal they wanted for a morning snack . Study 2 was a within-subject design involving 18 elementary school age children at a summer camp who were given a small ( 8 oz ) cereal bowl on one day and a large ( 16 oz ) cereal bowl on another day and asked by a cafeteria server how much cereal and milk they wanted for breakfast . Methods : Hidden scales measured how much cereal and milk were served , consumed , and wasted . BMI levels were obtained at the end of the study . Results : Study 1 indicated that younger children requested almost twice cereal to eat when presented with a larger bowl . Study 2 shows that older children consumed 52 % more and wasted 26 % more when served with a larger bowl . Conclusion : An immediate step to reducing overeating would be for parents and adult caregivers to use smaller bowls when serving food to children BACKGROUND Because people eat most of what they serve themselves , any context ual cues that lead them to over-serve should lead them to over-eat . In building on the size-contrast illusion , this research examines whether the size of a bowl or serving spoon unknowingly biases how much a person serves and eats . METHODS The 2 x 2 between-subjects design involved 85 nutrition experts who were attending an ice cream social to celebrate the success of a colleague in 2002 . They were r and omly given either a smaller ( 17 oz ) or a larger ( 34 oz ) bowl and either a smaller ( 2 oz ) or larger ( 3 oz ) ice cream scoop . After serving themselves , they completed a brief survey as their ice cream was weighed . The analysis was conducted in 2003 . RESULTS Even when nutrition experts were given a larger bowl , they served themselves 31.0 % more ( 6.25 vs 4.77 oz , F(1 , 80 ) = 8.05 , p < 0.01 ) without being aware of it . Their servings increased by 14.5 % when they were given a larger serving spoon ( 5.77 vs 5.04 oz , F(1 , 80)=2.70 , p = 0.10 ) . CONCLUSIONS People could try using the size of their bowls and possibly serving spoons to help them better control how much they consume . Those interested in losing weight should use smaller bowls and spoons , while those needing to gain weight -- such as the undernourished or aged -- could be encouraged to use larger ones . Epidemiologic implication s are discussed BACKGROUND Smaller plates are often recommended as a strategy for controlling energy intake ; however , the effect of plate size on meal energy intake in normal weight compared to overweight or obese individuals is not known . The present study aim ed to investigate this further . METHODS Ten normal weight [ mean ( SD ) body mass index , 21.7 ( 2.0 ) kg m(-2 ) ] and 10 overweight or obese [ 31.7 ( 3.6 ) kg m(-2 ) ] women attended a metabolic laboratory on two separate days for lunch . In this cross-over study , subjects were r and omly assigned to eat lunch using either a small ( 21.6 cm ) or a large ( 27.4 cm ) plate . Each subject self-served spaghetti mixed with tomato sauce from an individual serving bowl onto the assigned plate , and ate until satisfied . The meal was consumed alone at a private table . During the second study day , each subject underwent the same procedure but used the alternate size plate . The amount eaten and energy consumed were calculated and a mixed effects analysis of variance model was used to compare energy intakes . RESULTS Energy intakes using the small and large plate were 1356 ( 515 ) and 1365 ( 393 ) kJ , respectively , in normal weight subjects and 1314 ( 632 ) and 1226 ( 431 ) kJ , respectively , in overweight/obese subjects . Neither plate size , nor plate size by weight status significantly affected meal energy intake . There was no plate size by weight status effect on ratings of palatability , hunger , satiety , fullness or prospect i ve consumption . CONCLUSIONS Plate size did not affect energy intake from a single meal in either the normal weight or overweight/obese subjects 
    Output:
    
With all available data included , analysis indicated a marginal effect of dishware size on food intake , with larger dishware size associated with greater intake .