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Objective To identify the characteristics of people consuming olestra-containing foods when first introduced at a test-marketing site. Design Data are from the Olestra Postmarketing Surveillance Study (OPMSS). After the introduction of olestra into a large test-marketing site, study participants received 3 follow-up telephone calls, at 3-month intervals, in which they were questioned about their diets during the previous month. Subjects/setting 1,007 adults in Indianapolis, Ind, who participated in a baseline clinic visit (before introduction of olestra into the food market) and completed at least 2 of 3 follow-up telephone calls (after the introduction of olestra into the market). Statistical analyses performed Logistic regression was used to examine associations between olestra consumption and sociodemographic characteristics, health conditions, attitudes toward health and diet, and health-related behaviors. Results Olestra consumption on at least 1 of the follow-up telephone calls was reported by 41.5% of the study sample, and consumption on 2 or more telephone calls was reported by 20.0% of the sample. Factors associated with early adoption of olestra-containing foods included white ethnicity, higher education, overweight, absence of diabetes, attitudes indicative of diet and health concerns (eg, perceptions that there is a strong relationship between diet and disease), and a lower fat intake. Applications/conclusions In spite of the controversy surrounding the introduction of olestra into the food market, persons with attitudes indicative of diet and health concerns were likely to be early adopters of olestra-containing foods. Dietitians and other health care providers should inquire about intake levels of foods with fat substitutes and ensure that these foods are not being consumed in excessive amounts or being consumed instead of nutrient-dense foods that are naturally low in fat. J Am Diet Assoc. 2000; 100: 198–204.

Objective To describe the design of the Olestra Postmarketing Surveillance Study (OPMSS) and to present baseline results from the sentinel site. The purpose of the OPMSS is to monitor consumption patterns of olestra-containing snacks and to determine whether consumption affects nutritional status. Design The OPMSS combines repeated cross-section, random-digit dial telephone surveys before and after the market release of olestra-containing foods as well as intensive dietary and clinical assessments on a subsample of survey participants. Subjects Data are from baseline telephone (n=1,962) and clinical (n=1,069) assessment of participants (aged 18 to 74 years) in the Marion County, Indiana, sentinel site. Mean age of participants in the telephone survey was 43.2 years; 19% of respondents were black and 29% had completed college. Statistical analysis Analyses examined associations among savory snack use, fruit and vegetable consumption, and demographic and health-related characteristics. Data from the telephone survey were adjusted to be representative of the Marion County population. Results Almost 96% of the population surveyed had eaten savory snacks in the month before the survey: 74% had eaten regular-fat, 26% fat-reduced, and 78% nonfat types. Total snack consumption did not differ by gender, education, or race. Residents younger than 35 years ate snacks 16 times a month compared with 12 times a month among older residents. Types of snacks consumed differed markedly by demographic characteristics. Male, younger, and less educated residents ate more regular-fat snacks; female, white, and college-educated residents ate more nonfat snacks. In general, residents practicing healthful behaviors, including not smoking, eating fruits and vegetables, and exercising, also ate fewer regular-fat and more nonfat snacks. Fat intake was also related linearly to use of snack foods, ranging from 33.2% of energy among those consuming 1 serving per month or less to 36.8% among those consuming 20 or more servings per month. Applications/conclusions Procedures for recruitment and nutrition assessment appear adequate for evaluating the impact of olestra consumption on nutritional status. Nutritionists should be aware that there is potential for relatively high olestra consumption, given that almost 35% of Marion County residents eat snack foods at least 20 times a month. Consumers eating at least 20 servings of snacks per month derived more than 12% of their total energy and fat from snack foods, which suggests that substituting olestra snacks could substantially reduce intakes of fat and energy. J Am Diet Assoc. 1998;98:1290–1296 .

In 1987, Procter and Gamble Company (Cincinnati, Ohio) petitioned the US Food and Drug Administration (FDA) to amend the food additive regulations to allow sucrose esterified with fatty acids (olestra) to be used as a replacement for conventional fats. The petitioner later restricted its request for use in savory snacks. FDA considered evidence submitted by the petitioner, the opinions of experts, proceedings from the FDA Food Advisory Committee, and public discussion and concluded on January 25, 1996, that olestra was safe for use in savory snacks (eg, salty snacks such as potato chips, corn chips). Olestra is not toxic, carcinogenic, genotoxic, or teratogenic and is neither absorbed nor metabolized by the body, but may be associated with gastrointestinal tract symptoms such as cramping or loose stools. In addition, olestra affects the absorption of fat-soluble vitamins but does not affect the absorption of water-soluble nutrients. The petitioner's studies concluded that when olestra was consumed with foods containing vitamins A, D, E, or K, the fat substitute could have an effect on the absorption of these nutrients. Therefore, FDA is requiring that fat-soluble vitamins lost through absorption be added back to olestra as follows: 170 IU vitamin A per gram olestra, 12 IU vitamin D per gram olestra, 2.8 IU vitamin E per gram olestra, and 8 micrograms vitamin K per gram olestra. As part of the conditions of approval FDA is requiring that the food labels of products containing olestra disclose the vitamin compensation and the potential gastrointestinal effects. FDA is also requiring that further studies examining consumption patterns and the effects of olestra on human beings be conducted.

Given the extraordinary dietary and geographic diversity of Pleistocene hominids, there is no single "Paleolithic diet" or average pre-Holocene fat intake. Even the Neanderthals initially were scavengers, possibly becoming seasonal hunters of large game at a later period. Fat intakes of greater than 20 g/day (11% of total caloric intake) developed after the domestication of mammals and then by selective breeding of genetically fatter animals in suitably temperate climates. By the late 1940s, the percent of fat in the diet rose to more than 40% in many Western countries (including France), decreasing somewhat to about 35% by the late 1980s in the United States, following reduced consumption of whole milk, fried meats, and other high-fat foods. Overall, fat reductions to less than 30% may be facilitated by no-fat or low-fat substitutes or texturizers or (perhaps more effectively) by increased intakes of fiber and calcium and greater reliance on fats that are poorly absorbed because of their stearate content. J Am Diet Assoc. 1997;97:S54-S57 .

As individuals learn more about the potential negative health consequences of high-calorie and high-fat diets, their interest grows in rinding acceptable low calorie, reduced fat foods. Recently, the fat replacement olestra has received much attention from both health professionals and the general public. This study investigated the knowledge, attitude, and behaviors of registered dietitians (RDs) concerning olestra, Four hundred fifty-one RDs in Pennsylvania were mailed questionnaires. After eliminating unusable surveys, 294 questionnaires were analyzed (response rate=67%). Results included a mean knowledge score of 15 (SD = 2.35) out of a maximum of 25, mean attitudinal score of 15 (SD = 2.57) out of a maximum of 20, and mean behavior score of 11 (SD = 4.8) out of a maximum of 25. Moderate positive correlations for knowledge and attitudes, knowledge and behavior, as well as attitudes and behavior were all significant at the 0.05 level. Thus, as knowledge increased and attitudes were more positive, RDs increasingly endorsed olestra use. Although current research indicates that olestra, if used in moderation, is a safe fat replacement, only 49% of the respondents felt that the Food and Drug Administration (FDA) was correct in their decision to approve it. RDs need to possess attitudes mat reflect unbiased correct information. As many new products containing olestra begin to appear in the marketplace, RDs have the responsibility to be open-minded in order to help the general public make well-informed choices.