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Background  The aim of this research was to investigate whether increased portion sizes of vegetables and decreased portion sizes of meat on main dishes increased the amount of vegetables consumed in a real-life restaurant setting without affecting customer satisfaction. The participants were unaware of the experiment.    Methods  A cross-over design was used in which three restaurants were randomly assigned to a sequence of an intervention and control condition. In the intervention period, the vegetable portion sizes on the plates of main dishes were doubled (150 g of vegetables instead of 75 g) and the portion sizes of meat on the plates were reduced by an average of 12.5%. In the control period, the portion sizes of the main dishes were maintained as usual. In total, 1006 observations and questionnaires were included.    Results  Vegetable consumption from plates was significantly higher during the intervention period ( M  = 115.5 g) than during the control period ( M  = 61.7 g). Similarly, total vegetable consumption (including side dishes) was significantly higher during the intervention period ( M  = 178.0 g) than during the control period ( M  = 137.0 g). Conversely, meat consumption was significantly lower during the intervention period ( M  = 183.1 g) than during the control period ( M  = 211.1 g). Satisfaction with the restaurant visit did not differ between the intervention period ( M  = 1.27) and control period ( M  = 1.35). Satisfaction with the main dish was significantly lower during the intervention period ( M  = 1.25) than during the control period ( M  = 1.38), although in both cases, the scores indicated that participants remained (very) satisfied with their main dish.    Conclusions  This study showed that increasing vegetable portions in combination with decreasing meat portions (unknowingly to the consumer) increased the amount of vegetables consumed and decreased the amount of meat consumed. Furthermore, despite the changes in portion sizes, participants remained satisfied with their restaurant visit and main dish. The findings of this study suggest that modifying portion size in restaurants is an effective tool for stimulating vegetable consumption and consequently healthy and sustainable diets.

Menu-engineering in restaurants - adapting portion sizes on plates to enhance vegetable consumption: a real-life experiment