Portion Swapping: One small bite for mankind

Published: Thursday, May 4, 2023
Family Medicine Resident

Dave is 49 years old. Dave is obese, has high blood pressure and high cholesterol. He was recently told by his physician that losing weight would help improve his blood pressure and cholesterol. His physician recommended he make adjustments to his diet by implementing portion swapping. Dave has tried unsuccessfully to lose weight before, but he has not heard of this method. Later that week his family goes to a steakhouse. Dave is craving his usual 12-ounce steak, but after reading about portion swapping, he has a decision to make.

Dave is like many people living in America today. By 2030, it is estimated half of the US population will be obese. Obesity is a complicated disease caused by a combination of behavioral and genetic factors. While we often focus on individual behavior, other factors like familial behavior and societal culture around eating also influence our decisions (who didn’t grow up avoiding Brussel sprouts because we heard they were gross or “clean our plate” despite feeling full?). Genetics also influence our ability to lose weight, such as those with a family history of insulin resistance, but they do not get the final say in if we can shed the pounds or not.

Obesity Treatment Options

Obesity treatment options range from a variety of medications to different surgeries, but the initial step for anyone desiring weight loss is through lifestyle changes. This is brought up by physicians at countless visits each year by telling their patient to eat a healthy diet and exercise. While both are important, diet is the key component for initiating weight loss.

When the goal is to burn more calories than taken in, it is easier and practical to eat less calorie dense foods than it is to exercise more. Adjusting our diet can feel hard, but there’s a reason for it. We have been wired to eat the stuff that’s “bad” for us – salty, sweet, fatty – and companies have developed hyperpalatable foods to market to us. These salty, sweet, rich foods hijack our palate by stimulating appetite, metabolic, and stress hormones which play a role in cravings. But there is a method to make dietary choices that will lower markers of metabolic disease: portion swapping. 

Portion Swapping

Portion swapping is a method to transition toward healthy eating without completely cutting out highly craved foods at all once. Simply put, the less healthy food that’s currently the focus of the meal, swaps places with the healthier options on your plate.

This method retrains the palate and associates healthy foods with feeling satisfied from a lower calorie, yet filling, meal. Including smaller portions of animal protein with meals consisting of lower calorie plant-based protein, vegetables, whole grains, and fruit may prevent binging after trying to abstain for a period of time. Similarly, this method can be applied to desserts by swapping the portion size of the sweet with a healthier garnish. The most enjoyable bites of dessert are the first few, so a couple of bites is usually enough to satisfy the sweet craving at the end of a meal.

While this method won’t work for every scenario or meal, the goal is to swap or “flip” the portion of an unhealthy food with the healthier food on the plate.

Portion Swapping in Practice

Let’s get back to Dave and see how he implements portion swapping: Instead of ordering his usual 12-ounce steak and a side, Dave orders a 6-ounce steak with two vegetables on the side. While on the way home Dave and his family stop at an ice cream stand. Instead of ordering a hot fudge sundae, he chooses a small banana split topped with walnuts and strawberries.

While it might not look like much has changed, Dave increased his intake of vegetables, plant-based sources of protein, fruit, and reduced his consumption of animal fat and empty calories – all while still enjoying his food. Over time, Dave begins to order a steak salad and enjoys after-dinner fruit and nuts. He enjoys his meals, feels full, and, because of the lower calorie content, he is steadily losing weight.

Portion swapping lowered his markers of metabolic disease through gradually retraining his palate to enjoy nutritious, less calorie-dense food without ignoring cravings.

Next time you’re craving something unhealthy, consider giving portion swapping a try!

Learn More

Remember, you can always talk to your physician about portion swapping, or any other weight-loss options. If you don’t have a primary care provider, visit www.ngpg.org/providers to schedule an appointment today.

For additional information regarding diet and implementing lifestyle changes, go to: