The diet and health knowledge survey: development of a short interview format.

The primary aim of this study was to create a condensed short-form version of the structured interview named the Diet and Health Knowledge Survey (DHKS 1994-1996) via factor analysis. Data from 5765 participants of the 1994-1996 Diet and Health Knowledge Survey were used in the factor analysis. Appropriate sampling weights were used in the multivariate analyses (n=5233) that compared subgroups (i.e., ethnic group, sex, etc.) on the subscales of the DHKS. A 50-item, 12-factor condensed version of the 149-item original DHKS was derived from the analyses. Multivariate analyses, using age and education as covariates, indicated significant differences in dietary beliefs, practices, and behaviors for individuals of different ethnic groups, sex, dieting status, and BMI. Based on our analyses, the condensed short-form version of the Diet and Health Knowledge Survey appears to be a convenient and efficient tool, used in sections or in its entirety, for examining various dietary practices and beliefs of adults. The results from analysis of the short-form DHKS indicate that although a very large proportion of adults in the U.S. are overweight or obese, only a small proportion report current dieting. Examination of the DHKS indicates that although adults varied in their dietary beliefs and practices, dieters tended to report healthier dietary practices and attitudes than non-dieters. BMI level was positively related to self-reported amount of fat, cholesterol, and calories consumed.

A pilot church-based weight loss program for African-American adults using church members as health educators: a comparison of individual and group intervention.

OBJECTIVE: The purpose of this study was to examine a church-based intervention employing a 6-month pilot weight loss program as a strategy to improve health of African-American adults. DESIGN: A randomized trial design was used without a control group. Eligible church members were randomized into two groups: an intervention delivered in the group setting and an intervention delivered in the individual setting. SETTING: The study was conducted at an African-American church in Baton Rouge, Louisiana. PARTICIPANTS: Forty church members were enrolled in the study. Two trained church members without specialization in obesity treatment conducted the study. MAIN OUTCOME MEASURES: The primary outcome measure was weight loss. RESULTS: The program retention rate was 90%. After six months, a modest but significant mean weight loss was seen in all participants of 3.3 kg. The mean weight losses in the individual and group interventions were 3.4 kg and 3.1 kg, respectively. The mean body fat loss was 2.1 kg and 1.9 kg, respectively. The difference in weight loss and fat loss between the individual and group interventions was not statistically significant. An improvement in the quality of life and an increase in physical activity were reported by the program participants. CONCLUSIONS: A church setting may provide an effective delivery mechanism for a health and nutrition program. Church members may be trained to conduct a weight control program. Both interventions (individual and group) were effective in inducing weight loss.

Dietary fat and obesity: a review of animal, clinical and epidemiological studies.

The First Law of Thermodynamics provides a framework for understanding the imbalance between energy intake and expenditure that produces obesity, but it does not help understand the role of genetics, the regulation of food intake, the distribution of body fat, the mechanisms by which diets work or the mechanism by which portion control has gotten out of control. In animals, increasing dietary fat increases body fat, and it is unlikely that humans escape this important biological rule. In epidemiological studies, increasing dietary fat is associated with increased prevalence of obesity probably by increasing the intake of energy dense foods. In the National Weight Loss Registry, three things were associated with weight loss: continued monitoring of food intake, lowering dietary fat intake, and increased exercise. The relation of dietary fat is most evident when physical activity is low. The speed of adaptation to dietary fat is increased by exercise. When dietary fat is reduced, weight is lost, but weight loss eventually plateaus. The rate of weight loss during the initial phase is about 1.6 g/day for each 1% decrease in fat intake. When dietary fat is replaced with olestra to reduce fat intake from 33% to 25% in obese men, weight loss continues for about 9 months reaching a maximum of nearly 6% of body weight and a loss of 18% of initial body fat. In the control group with a 25% reduced-fat diet, weight loss stopped after 3 months and was regained over the next 6 months, indicating the difficulty of adhering to a conventional low-fat diet. Thus, dietary fat is an important contributor to obesity in some people.

Americans on diet: results from the 1994-1996 Continuing Survey of Food Intakes by Individuals.

OBJECTIVE: To examine the prevalence of dieting to lose weight or for a health reason in a representative sample of US adults. DESIGN: Cross-sectional study design. SUBJECTS/SETTING: Data from 10,144 participants of the 1994-1996 Continuing Survey of Food Intakes by Individuals (CSFII 1994-1996) were used in the analysis. All data were self-reported. STATISTICAL ANALYSIS: Analysis included: cross-tabulation of dieting status by sociodemographic characteristics; comparison of the type of diet, the reason for dieting, and the source of diet used by men and women; comparison of the nutrient intake and health status of dieters and nondieters. RESULTS: Prevalence of dieting varied by gender and race, being highest in white women (21%) and lowest in Hispanic men (8%). About 71% of all dieters reported that they were dieting to improve health, and 50% reported that they were dieting to lose weight. Dieters reported lower intakes of total fat, saturated fat, cholesterol, sodium, monounsaturated fat, polyunsaturated fat, calcium, and selenium compared with nondieters. The rate of chronic health conditions was higher among dieters than nondieters. Self-reported physical activity was similar in both groups. CONCLUSIONS: The prevalence of dieting varies according to sociodemographic characteristics. The reason for dieting and the type of diet used by dieters also vary and need to be studied further. Our results suggest that the dieters generally consumed a more nutrient-dense diet than the nondieters but still low in certain nutrients.

Fast-food consumption among US adults and children: dietary and nutrient intake profile.

OBJECTIVE: To examine the dietary profile associated with fast-food use. To compare the dietary intake of individuals on the day that they ate fast food with the day that fast food was not eaten. DESIGN: Cross-sectional study design. The dietary intake of individuals who reported eating fast food on one or both survey days was compared with those who did not report eating fast food. Among the individuals who reported eating fast food, dietary intake on the day when fast food was eaten was compared with the day when fast food was not eaten. Weighted comparison of mean intakes and pairwise t-test were used in the statistical analysis. Subjects/setting Data from 17370 adults and children who participated in the 1994-1996 and 1998 Continuing Survey of Food Intakes by Individuals. Dietary intake data were collected by 2 non-consecutive 24-hour dietary recalls. RESULTS: Fast-food use was reported by 37% of the adults and 42% of the children. Adults and children who reported eating fast food had higher intake of energy, fat, saturated fat, sodium, carbonated soft drink, and lower intake of vitamins A and C, milk, fruits and vegetables than those who did not reported eating fast food (P<.001). Similar differences were observed among individuals between the day when fast food was eaten and the day when fast food was not eaten. CONCLUSIONS: Consumers should be aware that consumption of high-fat fast food may contribute to higher energy and fat intake, and lower intake of healthful nutrients.

Sex, race/ethnicity, socioeconomic status, and BMI in relation to self-perception of overweight.

OBJECTIVE: To compare the self-perception of overweight in the study population according to sex, race/ethnicity, and socioeconomic status and to compare the self-perception of overweight among individuals classified as normal weight, overweight, and obese. RESEARCH METHODS AND PROCEDURES: Data from 5440 adults who participated in the 1994 to 1996 Continuing Survey of Food Intakes by Individuals and the Diet and Health Knowledge Survey conducted by the U.S. Department of Agriculture were analyzed. Data for analysis included self-perceived weight status, self-reported weight and height, and demographic and socioeconomic data. Underweight individuals, defined as those with a body mass index <18.5 kg/m2, were excluded from the analysis. RESULTS: Self-perception of overweight was more common in women compared with men and in whites compared with blacks or Hispanics. Both the correct and incorrect perception of overweight was more common in normal weight and overweight white women compared with black women. More overweight and obese white men correctly perceived their overweight status compared with black men. Multiple logistic regression showed that the odds ratio of perceived overweight was significantly higher in women, whites, and individuals with higher body mass index, higher income, and higher education. DISCUSSION: Self-perceived overweight varied by sex, race/ethnicity, and socioeconomic status. Erroneous perception of body weight may have important health and behavioral implications. In particular, a considerable proportion of overweight men may be at risk of obesity if they continue to perceive themselves as having normal weight.