Library Index :: Weight in America: Obesity, Eating Disorders, and Other Health Risks :: Preventing Overweight and Obesity - Prevention Efforts Target Families, Communities, And Schools, Is Nutrition Education Working To Improve Americans' Diets?

Preventing Overweight and Obesity - Is Nutrition Education Working To Improve Americans' Diets?

In August 2002 NPD Foodworld reported that the Healthy Eating Index (HEI), a measure developed in 1990 by the USDA to assess the health value of Americans' diets, was the lowest it had been since 1998. The HEI is a summary measure of overall diet quality. It captures the type and quantity of foods people eat and the degree to which diets comply with specific recommendations in the USDA Dietary Guidelines and the Food Guide Pyramid. The HEI assigns points for eating consistently within USDA guidelines. It assesses ten dietary components—grains, vegetables, fruits, milk, meat, total fat, total saturated fat, cholesterol, sodium, and a varied diet—on a scale of zero to ten. Individuals who eat TABLE 10.11 MyPyramid worksheet "MyPyramid Worksheet," at MyPyramid.gov, United States Department of Agriculture, August 2005, http://mypyramid.gov/downloads/worksheets/Worksheet2000 18.pdf (accessed January 14, 2006)

TABLE 10.11
MyPyramid worksheet
Check how you did today set a goal to am for tomorrow
Write in your choices for today Food group Tip Goal based on a 2000-calorle pattern List each food choice in its food group* Estimate your total
SOURCE: "MyPyramid Worksheet," at MyPyramid.gov, United States Department of Agriculture, August 2005, http://mypyramid.gov/downloads/worksheets/Worksheet200018.pdf (accessed January 14, 2006)
Grains
Make at least half your grains whole grains 6 ounce equivalents (1 ounce equivalent is about 1 slice bread, 1 cup dry cereal, or 1/2 cup cooked rice, pasta, or cereal)
__________________________ __________________________
__________________________ __________________________ __________________________
__________________________ __________________________ ounce equivalents
__________________________
__________________________ Vegetables
Try to have vegetables from several subgroups each day 2 1/2 cups
Subgroups: dark green, orange, starchy, dry beans and peas, other veggies
__________________________
__________________________ __________________________ __________________________
__________________________ __________________________ cups
__________________________
__________________________ Fruits
Make most choices fruit, not juice 2 cups __________________________
__________________________ __________________________ __________________________
__________________________ __________________________ cups
__________________________
__________________________ Milk
Choose fat-free or low fat most often 3 cups (1 1/2 ounces cheese=1 cup milk) __________________________
__________________________ __________________________ __________________________
__________________________ __________________________ cups
__________________________
__________________________ Meat & beans
Choose lean meat and poultry. Vary your choices—more fish, beans, peas, nuts, and seeds 5 1/2 ounce equivalents (1 ounce equivalent is 1 ounce meat, poultry, or fish, 1 egg, 1 T. peanut butter, 1/2 ounce nuts, or 1/4 cup dry beans) __________________________
__________________________ __________________________ __________________________
__________________________ __________________________ ounce equivalents
__________________________
__________________________ Physical
Build more physical activity into your daily routine at home and work. At least 30 minutes of moderate to vigorous activity a day, 10 minutes or more at a time. *Some foods don't fit into any group. These "extras" may be mainly fat or sugar—limit your intake of these.
__________________________ __________________________
__________________________ minutes
How did you do today?   □Great □So-so □Not so great
My food goal for tomorrow is:_____________________________________________________________________________
My activity goal for tomorrow is:________________________________________________________________________

TABLE 10.12 Contribution of various foods to trans fat intake in diet "Table 11. Contribution of Various Foods to Trans Fat Intake in the American Diet (Mean Intake = 5.84 g)," in Dietary Guidelines for Americans, 2005, Chapter 6: Fats, U.S. Department of Health and Human Services, U.S. Department of Agriculture, January 12, 2005, http://www.health.gov/dietaryguidelines/dga2005/document/pdf/Chapter6.pdf (accessed January 14, 2006)

TABLE 10.12
Contribution of various foods to trans fat intake in diet
Food group Contribution (percent of total trans fats consumed)
*Includes breakfast cereal and candy. USDA analysis reported 0 grams of trans fats in salad dressing.
SOURCE: "Table 11. Contribution of Various Foods to Trans Fat Intake in the American Diet (Mean Intake = 5.84 g)," in Dietary Guidelines for Americans, 2005, Chapter 6: Fats, U.S. Department of Health and Human Services, U.S. Department of Agriculture, January 12, 2005, http://www.health.gov/dietaryguidelines/dga2005/document/pdf/Chapter6.pdf (accessed January 14, 2006)
Cakes, cookies, crackers, pies, bread, etc. 40
Animal products 21
Margarine 17
Fried potatoes 8
Potato chips, corn chips, popcorn 5
Household shortening 4
Other* 5

grains, vegetables, fruits, milk, meat (including chicken and fish), as well as a variety of foods at or above the USDA recommended levels receive a maximum score often. A score of zero is assigned when the recommended amount of those components is not eaten. For fat, saturated fat, cholesterol, and sodium, a score of ten is awarded for eating the recommended amount or less. The highest possible score is a hundred, and a score of eighty or above is considered a healthy diet, scores between fifty-one and eighty show a need for dietary improvement, and scores below fifty indicate poor diets.

Still, some evidence indicates that Americans' food purchasing and eating habits were changing. In November 2004 the market research firm NPD Group reported that the top five items adults look for on nutrition labels were:

  • Total fat
  • Total calories

FIGURE 10.2 MyPyramid for kids "My Pyramid for Kids," at MyPyramid.gov, United States Department of Agriculture, September 2005, http://teamnutrition.usda.gov/Resources/mpk_poster2.pdf (accessed January 13, 2006)

MyPyramid for kids "My Pyramid for Kids," at MyPyramid.gov, United States Department of Agriculture, September 2005, http://teamnutrition.usda.gov/Resources/mpk_poster2.pdf (accessed January 13, 2006)

For an 1,800-calorie diet, you need amounts below from each food group. To find the amounts that are right for you, go to MyPrymaid.gov.
Grains Eat 6 oz. every day; at least half should be whole
Vegetables Eat 2 1/2 cups every day
Fruits Eat 1 1/2 cups every day
Milk Get 3 cups every day; for kids ages 2 to 8, it's 2 cups
Meat & beans Eat 5 oz. every day
Find your balance between food and fun
Move more. Aim for at least 60 minutes everyday, or most days.
Walk, dance, bike, rollerblade—it all counts. How great is that!
Fats and sugars—know your limits
Get your fat facts and sugar smarts from the Nutrition Facts label.
Limit solid fats as well as foods that contain them.
Choose food and beverages low in added sugars and other caloric sweeteners.
SOURCE: "My Pyramid for Kids," at MyPyramid.gov, United States Department of Agriculture, September 2005, http://teamnutrition.usda.gov/Resources/mpk_poster2.pdf (accessed January 13, 2006)
Grains
Make half your grains whole
Start smart with breakfast. Look for whole-grain cereals. Just because bread is brown doesn't mean it's whole-grain. Search the ingredients list to make sure the first word is "whole" (like "whole wheat").
Vegetables
Vary your veggies
Color your plate with all kinds of great-tasting veggies. What's green and orange and tastes good? Veggies! Go dark green with broccoli and spinach, or try orange ones like carrots and sweet potatoes.
Fruits
Focus on fruits
Fruits are nature's treats—sweet and delicious. Go easy on juice and make sure it's 100%.
Oils Oils are not a food group, but you need some for good health. Get your oils from fish, nuts, and liquid oils such as corn oil, soybean oil, and canola oil.
Milk
Get your calcium-rich foods
Move to the milk group to get your calcium. Calcum builds strong bones. Look at the carton or container to make sure your milk, yogurt, or cheese is lowfat or fat-free.
Meat & beans
Go lean with protein
Eat lean or lowfat meat, chicken, turkey, and fish. Ask for it baked, broiled, or grilled—not fried. It's nutty, but true. Nuts, seeds, peas, and beans are all great sources of protein, too.
  • Sugar
  • Total carbohydrates
  • Calories from fat

Harry Balzer, NPD Foodworld vice president, named the resurgence of interest in slow cooking using a crockpot, increased consumption of fried chicken, decreased coffee consumption, increased milk sales by fast food outlets, and consumers expressing a preference for salads but purchasing burgers, as the biggest surprises of the 2004 food industry survey ("The Dieting Monitor/Consumer Information," NPD Insights, January 2005).

TABLE 10.13 MyPyramid worksheet for kids "MyPyramid Worksheet," at MyPyramid.gov, United States Department of Agriculture, September 2005, http://teamnutrition.usda.gov/resources/mpk_worksheet.pdf (accessed January 13, 2006)

TABLE 10.13
MyPyramid worksheet for kids
MyPyramid
Name:______________________________________________________________________
Check how you did yesterday and set a goal to aim for tomorrow                                                                      For Kids
Write in your choices from yesterday Food and activity Tips Goal List each food choice in its food group* Estimate your total
*Some foods don't fit into any group. These "extras" may be mainly fat or sugar—limit your intake of these.
SOURCE: "MyPyramid Worksheet," at MyPyramid.gov, United States Department of Agriculture, September 2005, http://teamnutrition.usda.gov/resources/mpk_worksheet.pdf (accessed January 13, 2006)
Breakfast: Grains
Make at least half your grains whole grains. 6 ounce equivalents
(1 ounce equivalents is about 1 slice bread, 1 cup dry cereal, or 1/2 cup cooked rice, pasta, or cereal)
_________________________ _________________________
_________________________ _________________________ ___________________
_________________________ _________________________ ounce equivalents
_________________________
_________________________
_________________________
Lunch: Vegetables
Color your plate with all kinds of great tasting veggies. 2 1/2 cups
(Choose from dark green, orange, starchy, dry beans and peas, or other veggies).
_________________________ ____________________
_________________________ _________________________ cups
_________________________
_________________________ _________________________
_________________________ ____________________
Snack: Fruits
Make most choices fruit, not juice. 1 1/2 cups
_________________________ _________________________ cups
Dinner: Milk
Choose fat-free or lowfat most often. 3 cups
(1 cup yogurt or 1 1/2 ounces cheese=1 cup milk)
_________________________
_________________________ _________________________ ____________________
_________________________ _________________________ cups
_________________________
_________________________
_________________________ Meat and beans
Choose lean meat and chicken or turkey. Vary your choices—more fish, beans, peas, nuts, and seeds. 5 ounce equivalents
(1 ounce equivalent is 1 ounce meat, chicken or turkey, or fish, 1 egg, 1 T. peanut butter, 1/2 ounce nuts, or 1/4 cup dry beans)
_________________________
_________________________ _________________________ ____________________
_________________________ _________________________ ounce equivalents
_________________________
_________________________
_________________________
Physical activity: Physical activity
Build more physical activity into your daily routine at home and school. At least 60 minutes of moderate to vigorous activity a day or most days. _________________________ ____________________
_________________________ _________________________ minutes
_________________________
How did you do yeaterday?     □Great $#x25A1;So-so $#x25A1;Not so great
My food goal for tomorrow is:________________________________________________________________________
My activity goal for tomorrow is:______________________________________________________________________

The NPD Group's 20th Annual Eating Patterns in America report, released in October 2005, examined what consumers are eating, where they buy their food and beverages, who prepares meals, the most popular foods at each meal, and which appliances are used in meal preparation. The survey's key findings include comparisons with consumption patterns from the mid-1980s:

  • In 2005, 53% of people said they try to avoid snacking, compared with 71% in 1985.
  • The annual number of main meals skipped per person rose from 102 in 1985 to 114 in 2005.
  • Americans are using stovetops less (down 18% from 1985), and microwave ovens more—microwave use doubled from 10% in 1985 to 20% in 2005.
  • Americans were significantly more accepting of people who were overweight in 2005 than they were in 1985. In 1985, 55% of respondents completely agreed with the statement, "People who are not overweight look a lot more attractive." In 2005 just 24% completely agree with the same statement.
  • Consumer concerns have changed from reducing sodium intake in 1985, to eliminating trans fat from their diets in 2005.
  • In 2004, 75% of adults said they were trying to cut down or eliminate fat from their diet, and 61% said they were trying to add more whole grains.
  • The use of fresh products in main meals at home decreased in 2005 compared to 1985. In 1985, 56% of in-home main meals included a fresh product. In 2005, 46% of in-home main meals included a fresh product.

FIGURE 10.3 Consumption of fruits and vegetables per day, nationwide, 2003 "Consumption of Fruits and Vegetables Per Day—Nationwide, 2003," in "Adults Who Have Consumed Fruits and Vegetables Five or More Times Per Day," Behavioral Risk Factor Surveillance System Prevalence Data, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention & Health Promotion, June 15, 2005, http://apps.nccd.cdc.gov/brfss/display.asp?cat=FV&yr=2003& qkey=4415&state=US (accessed January 13, 2006)

  • Americans are more likely to see carbonated soft drinks included at all meal occasions, and less likely to see toast.

Americans' Snack Food Choices

In January 2004 the NPD Group released its first-ever study about Americans' snack food choices Snacking in America. The report found that such salty snacks as pretzels, chips, and tortilla chips account for about a quarter of the convenience foods Americans choose for snacks. Although children and teens snack on sugary treats such as candy, gum, chewy fruit snacks, and breath mints, which accounted for an additional 14% of snack food choices, some of the fastest growing snack foods among children and adolescents aged two to eighteen are healthier choices. Yogurt is the fastest growing snack food in terms of consumption frequency among children under thirteen years old. On average, children under thirteen ate yogurt eleven more times in the year ending June 2003 than they did three years earlier. Children aged two to seven ate yogurt as a snack nearly fourteen times more often in 2003 than they did in 1999, and children aged eight to twelve snacked on yogurt 8.5 times more in 2003 than five years earlier. Although children may be making some healthier choices when it comes to snacks, they also are snacking more frequently—in 2003 children and teens consumed about twenty-two more snacks per person per year than reported in 1999.

In June 2005, the NPD group reported that fruit was the number one snack food consumed by children aged two to twelve. Consumed more often than any other snack food, among boys aged two to seven, fresh fruit was followed by yogurt, potato chips, chocolate candy, and cookies. Girls the same age ranked fresh fruit first followed by yogurt, gum, potato chips, and chocolate candy. Boys aged eight to twelve named fresh fruit, potato chips, gum, ice cream, and chocolate candy as their top five picks, and girls aged eight to twelve said fresh fruit, gum, potato chips, ice cream, and chocolate candy were their favorite snack foods (NPD SnackTrack®, NPD Group, June 2005).

Chewing gum was the number one snack food named by adults aged eighteen to fifty-four in 2005. The NPD Group's SnackTrack® found that age was a factor in the gum-chewing habits of Americans. While gum was a popular snack among children under thirteen years old, it did not rank as number one until the teenage years. After gum, the top ranking snack foods among men in 2005 were chocolate candy, fresh fruit, potato chips, breath/candy mints, ice cream, nuts, cookies, tortilla chips, and bars. Women said chocolate candy, fresh fruit, potato chips, breath/candy mints, ice cream, cookies, nuts, yogurt, and crackers are their choices.

Research on Interventions to Promote Healthy Weight

An independent Task Force on Community Preventive Services appointed by the CDC to evaluate of community, population, and health-care system strategies to address a variety of public health and health promotion topics is presently assessing the effectiveness of interventions to promote healthy eating and physical activity. The Task Force review of the effectiveness of population based interventions to promote healthy growth and development of children and adolescents and support healthy weights among adults, focuses on school-based strategies, worksite programs, health-care system interventions, and community-wide initiatives.

By mid-year 2005, the Task Force review had, for example, concluded that worksite programs combining nutrition and physical activity were effective and recommended them as strategies to control overweight and obesity. The Task Force also determined that more evidence is needed to determine the effectiveness of school-based programs to control overweight and obesity. Table 10.14 shows the progress of the Task Force Review as of the third quarter of 2005. It is important to remember that "insufficient evidence to determine effectiveness" does not mean that an intervention does not work, but rather FIGURE 10.4 States funded to prevent obesity obesity and other chronic diseases, FY 2005 "States Funded in FY 2005," in Overweight and Obesity: State-Based Programs, Centers for Disease Control and Prevention, Division of Nutrition and Physical Activity, National Center for Chronic Disease Prevention and Health Promotion, October 4, 2005, http://www.cdc.gov/nccdphp/dnpa/obesity/state_programs/index.htm (accessed January 13, 2006)indicates that additional research is needed to determine whether the intervention is effective.

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