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Dietary energy density [kcal/g (kJ/g)] influences energy intake under controlled laboratory conditions. Little is known about the energy density of the diets of free-living persons. Because energy density investigations are a relatively new endeavor, there are neither standard calculation methods nor published nationally representative values. This paper examines the calculation of energy density based on systematic exclusion of beverage categories, presents data on variability, and compares values by sex, age, and race/ethnicity in a representative sample of U.S. adults. Mean daily dietary energy density values for adults (aged >19 y) were calculated using two 24-h recalls from the Continuing Survey of Food Intakes by Individuals 1994-1996 based on food, food and liquid meal replacements, food and alcohol, food and juice, food and milk, food and juice and milk, food and energy-containing beverages, and food and all beverages. Energy density varied by calculation method, ranging from 0.94 to 1.85 kcal/g (3.93-7.74 kJ/g). Intraindividual-to-interindividual CV ratios were highest for the food and energy-containing beverages calculation. Men reported diets with a higher energy density than women for all calculation methods (P < 0.0001). There were differences by race/ethnicity and an inverse linear trend for age. These data indicate that beverage inclusion schemes should be clearly defined when reporting energy density values. In epidemiologic studies, calculations based on food and all beverages and food and energy-containing beverages may diminish associations with outcome variables. These nationally representative data, which provide an important frame of reference for other studies, indicate that dietary energy density differs by sex, age, and race/ethnicity. [ABSTRACT FROM AUTHOR]

Primary care physicians have the potential to decrease morbidity and mortality for many chronic diseases if they provide effective nutrition counseling. Given the time constraints of primary care practice, nutrition counseling needs to be brief, be part of an organized office system and refer appropriate patients to qualified nutrition professionals to be effective. This paper reviews a system of primary care nutrition counseling using the 5A's of patient-centered counseling, the elements necessary to develop an office-based system and some successful tools developed by nutrition researchers for the primary care setting to be used in an office-based system. [ABSTRACT FROM AUTHOR]

Little is known concerning obesity patterns of ethnic subpopulations in the U.S. and the effects of acculturation on these patterns. Adolescent obesity, a major public health problem, has important health, social and economic consequences for the adolescent. The National Longitudinal Study of Adolescent Health survey is unique in the size of the adolescent sample and in its ability to provide large representative samples of Anglo, African-American, Hispanic and Asian-American adolescents. A nationally representative sample of 13,783 adolescents was studied. Measurements of weight and height collected in the second wave of the survey were used to study adolescent obesity. Multivariate logit techniques were used to provide an understanding of the ethnic, age, gender and intergenerational patterns of adolescent obesity. Comparisons are presented between the NHANES III results and those from the Adolescent Health Survey. The smoothed version of the NHANES I 85th percentile cut-off was used for the measure of obesity in this paper. For the total sample, 26.5% were obese. The rates were as follows: white non-Hispanics, 24.2%; black non-Hispanics, 30.9%; all Hispanics, 30.4%; and all Asian-Americans, 20.6%. Important variations within the Hispanic and Asian-American subpopulations are presented. The Chinese (15.3%) and Filipino (18.5%) samples showed substantially lower obesity than non-Hispanic whites. All groups showed more obesity among males than among females, except for blacks (27.4% for males and 34.0% for females). Asian-American and Hispanic adolescents born in the U.S. are more than twice as likely to be obese as are first generation residents of the 50 states. [ABSTRACT FROM AUTHOR]