A few days ago, I saw an article [link no longer functional] by AP writer Candice Choi that was picked up in our local paper titled:

Serving size a pitfall for label-readers. Americans often miscalculate, eating too much.

The article focused on a study done at Vanderbilt University Medical Center in Nashville, TN that looked into how well people can understand nutritional labels on products, a question for which, as it turns out, the answer is ‘not very well.’

Having been in the weight loss/diet/nutrition clinical trenches for twenty years or so, I could have saved them the money and told them in advance what the study ultimately proved: in the great majority, people don’t read labels on foods and even those who do read them often miss the part about serving number and serving size and even those who do recognize that a serving of beans as listed on the can is 1/2 cup will have the devil of a time correctly estimating the volume of 1/2 cup unless they measure.

Certainly all the blame can’t be laid on the consumer–although much of it must rest there–but also on the food manufacturers, who, in their desperation to make their products conform to the needs of target groups–low fat, low sodium, no trans fats, or low carb, to name a few–contort the serving size to suit their marketing need of the moment. I mean, a bottle of soda pop is a serving in the eyes of most consumers, not the multiple plus a fraction number of servings that lets the manufacturer slip under some pre-determined limit, adhering to the letter of the labelling laws, but not the spirit.

It’s all quite confusing to the av-er-age bear, as Yogi would say.

Veteran low carb dieters tend to be more conscious of the trickery employed by manufacturers than most consumers, I think, because experience has taught them to beware, but most of us have been hoodwinked at one time or another by a crafty labelers’ subterfuge.

That’s why, we always encouraged, urged, cajoled, and reminded our patients to:
1) read nutritional labels carefully for portion size, for carbs per portion, and for the presence of unhealthy additives, such as partially hydrogenated fats and oils, aspartame, MSG, nitrates, etc. in the ingredients listing.
2) measure portions carefully on carb rich foods, if they elected to eat them, so that the intended 1/8 cup of corn kernals doesn’t become 3/4 cup and with it the 5 grams of carb become 30.
3) keep a diet diary of all food consumed, at least when trying to correct a health issue or lose weight.

Yes, keeping a diet record is a pain in the keester, but like all worthwhile habits, it comes with rewards. Studies have shown that people trying to make a life change, in this case a dietary one, will be 4 times more likely to succeed if they record their intake and output honestly. We distributed a crisp new single sheet food and exercise diary each week to every one of our patients and expected them to do their part by entering everything that passed their lips each day–every bite, sip, prescription pill, or supplement–as well as all extra physical output. We, for our part, collected them and personally looked over every single entry every week, made comments, and returned them the following week.

If you’ve never undertaken the exercise of keeping a dietary record, I highly recommend it; if you’re like us and most of our patients over the years, it will prove to be an eye-opening experience if you do it with complete honesty.

These sorts of basic common knowledge tools or methods for success too often get shunted aside in the press to argue over the finer points of exercise or nutrition, but that doesn’t make them any less valid. Mike and I thought them so important for long term success that we included a 365 Day food/exercise journal (tailored, obviously, for a low carb diet) in our book Staying Power: Maintaining Your Low Carb Weight Loss for Good, published in 2005.

If when dieting, you hit a plateau in weight loss or in control of health measures, such as cholesterol, triglycerides, blood pressure, or blood sugar, going back to these basics can often provide the kick that gets things going again.

As is so often the case, it is doing the little things well that matters the most.


  1. Dr. Mary Dan-Hi! I faithfully kept a food diary while losing 140 lbs. I still do even in maintenence. I have a question about food lables. I never can get the estimated servings per can. For example a serving is a half cup and the can is suppsed to have 3 servings but I usually only end up with 2 servings. I’ve noticed this on tuna, peaches green beans, just about any canned product the stated servings is above the reality. Do they count the liquid as part of the serving? Any clarification you might have will be appreciated. Thanks!

    COMMENT from MD EADES: Congratulations on your great success–and for the testiment to the positive impact of journaling intake! As to the serving sizes, I suspect that all the liquid does count in the volume per serving, but that’s just an educated guess on my part

  2. It all comes down to the bugaboo of portion control. Nobody stops at one piece of bread or 1/2 cup of beans. Carbs are problematic in small quantities for so many of us, and the large portions needed to satify hunger are downright dangerous to health. Not to mention that some of us, especially me, are hungry twenty minutes after eating carbs, no matter what the quantity was.

    Food mfgs engage in out and out deceit when it comes to the servings they demo on the labels, knowing full well that their customers are not going to serve themselves such small portions.

    It is enabled by the moralistic school of weight loss, what I call the “IF ONLY” school. If only you would stick to the small portion. If only you would have the will power to do so. If only you would put up with the constant hunger of lowfat/highcarb !! No wonder the diet industry has a 98% failure rate !!

    COMMENT from MD EADES: There’s no doubt that even the smallest amount of a carby food can send some folks’ into metabolic mayhe. On the other hand, in our experience, everyone doesn’t fall into that group. We’ve had lots and lots of patients over the years who would every night eat a small amount–literally a 1/8 cup portion–of corn with their steak and salad and be perfectly content. Or who would enjoy 1 cup of popped popcorn each night as a treat after dinner and keep on ticking, which brings up a truth known since the times of the ancient Greeks: Know thyself!

  3. I’ve found journalling enormously useful, too. I don’t do it all the time, but any time I need to get back on track I do it. Just the fact that I’m writing everything down makes a difference in what I eat. And having the information from my journalling period gives me a reference for where I need to get back to if things have drifted.

    On the labelling issue, one of the few EU regulations that is actually helpful is that nutritional info is given for 100g (I assume it’s a regulation, not just a sudden attack of helpfulness from the food industry). Sometimes the manufacturer will add figures for what they consider to be a serving size, but the 100g reference is generally more useful. The only difficulty is that the longer I eat this way the fewer things I buy that actually have labels!

    By the way, I’m one of those who likes to eat small quantities of heavy duty carbs. I’ll have 1/4 cup of rice or a 1 oz slice of bread and be quite satisfied. In fact I find it makes the meal more filling, and stops me wanting to snack before the next meal. If I eat too much then I’ll be sleepy, not get hungry even when I do need to eat, retain fluid… lots of bad things. But small quantities keep me happy
    COMMENT from MD EADES: I agree, it’s helpful to have a standardized amount. On this side of the water, it’s the classic 3 1/2 ounce portion, which is also about 100 grams. Still, I think it’s better to also have the info that “this entire bag contains this amount of calories, carbs, whatever” and also what a usual portion would contain or how many usual portions are in the bag or box.

  4. What really hit me about labels recently was when my daughter’s boyfriend brought over this Ben and Jerry’s concoction in a glass bottle — a melted milkshake sort of drink thing — not something I would touch with a 10-foot pole but when he left, there was the bottle sitting on the counter, so I checked it out.

    I looked at the label to see how many grams of carbs were listed and was astounded to see that the single-serving bottle (about the size of a Frappucino bottle) had 54 grams of carbs.

    But I was further astounded when I noticed the “% Daily Value” figure. It said those 54 grams of carbs were 18% of the Daily Value for carbs. I went to the nearest calculator and figured out that if 54 grams is 18%, that means the “Daily Value” for carbohydrates is 300 grams!

    What I (or my bloodwork) would look like if I were eating 300 grams of carbs a day I do not even want to think about. –Anne

    COMMENT from MD EADES: Oh, I expect about what any non-serious-athlete’s bloodwork would look like after eating 300 grams, particularly if it were mainly made up of Ben and Jerry’s shakes. ;D

  5. We have a 9 year old boy that loves to eat and portion control is the real issue. Reading the food labels is a hard thing to understand. I guess if we can control the carb intake, that may be the key to preventing him from gaining too much weight, but are there other key things on the food label that we should watch? I want to get things that will fill him up quickly but not put the weight on too much. He is active, but at that age is saturated fat a concern as well as carbs on the label?

    COMMENT from MD EADES: In addition to carb watching, the quality of fat should be a key. Saturated fat, despite its bad rap, is fine. It’s the partially hydrogenated vegetable oils (ie partly saturated) that are trouble. Additionally processed soy isn’t such a good idea for a growing boy.

  6. Your last statement regarding, the little things, that resonate with me. I find it interesting that in matters of pleasure, such as food, that sticking to the rules regarding calorie intake the little things can be easily overlooked. Then the results catches up with us, increase weight.

  7. In the UK they now have labels actually stating if the product is good or bad. I think it’s a great idea and helps parents to understand which foods they should be choosing for their children. At the end of the day… stay away from processed from. All the best, Donna

    COMMENT from MD EADES: Unfortunately, what the powers that be over here at least would consider ‘good’ and ‘bad’ are not at all what I would agree with. There would be smiley faces on whole grain bagels and fat free milk and frownie faces on butter and beef.

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