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Objective Dietary supplements are not recommended as part of a weight-loss program due to concerns about efficacy and safety. This study sought to assess prevalence and duration of nonprescription weight-loss supplement use, associated weight-control behaviors, discussion of use with a health care professional, and specific ingredient use. Participants and design Adults aged [greater than or equal to] 18 years (n=9,403) completed a cross-sectional population-based telephone survey of health behaviors from September 2002 through December 2002. Statistical analyses performed Both [chi square] and t tests were conducted for categorical and mean comparisons and multiple variable logistic regression was used to determine significant predictors. Results An estimated 15.2% of adults (women 20.6%, men 9.7%) had ever used a weight-loss supplement and 8.7% had past year use (women 11.3%, men 6.0%); highest use was among women aged 18 to 34 years (16.7%). In regression models, use was equally prevalent among race/ethnic groups and education levels. One in 10 (10.2%) of users reported [greater than or equal to] 12 month use, with less frequent long-term use in women (7.7%) than men (15.0%), P=0.01. Almost one third (30.2%) of users discussed use during the past year; 73.8% used a supplement containing a stimulant including ephedra, caffeine, and/or bitter orange. Conclusions Use of supplements for losing weight seems to be common among many segments of the US adult population. Many adults are long-term users and most do not discuss this practice with their physician. Most of the weight-loss supplements taken contain stimulants. Qualified professionals should inquire about use of supplements for weight loss to facilitate discussion about the lack of efficacy data, possible adverse effects, as well as to dispel misinformation that may interfere with sound weight-management practices.

Objective This study investigated food choices made by individuals consuming diets differing in energy density and explores relationships between energy density and diet quality. Design Cross-sectional, nationally representative survey. Subjects 7,500 adults (older than 19 years) in the 1994-1996 Continuing Survey of Food Intakes by Individuals. Statistical analysis Energy density values were calculated from reported food intake. Subjects were classified as consuming a low-energy-density diet, medium-energy-density diet, or high-energy-density diet using tertile cutoffs. For each group, the percentage consuming various foods/beverages and the mean amount of foods/beverages they consumed was determined along with mean nutrient intakes. Results Compared with participants consuming a high-energy-density diet, those with a low-energy-density diet had a lower energy intake but consumed more food, by weight, from most food groups. A low-energy-density diet included a relatively high proportion of foods high in micronutrients and water and low in fat, such as fruits and vegetables. Subjects with a low-energy-density diet consumed fewer (nonwater) beverages such as caloric carbonated beverages. They also consumed less fat and had higher intakes of several important micronutrients, including vitamins A, C, and B-6, folate, iron, calcium, and potassium. Conclusions These analyses further demonstrate the beneficial effects of a low-energy-density diet, which was associated with lower energy intakes, higher food intakes, and higher diet quality than a high-energy-density diet. To achieve a low-energy-density diet, individuals should be encouraged to eat a variety of fruits and vegetables as well as low-fat/reduced-fat, nutrient-dense, and/or water-rich grains, dairy products, and meats/meat alternatives.

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. KEY WORDS: * energy density * intraindividual variation * methodology * diet

Objective. Although many studies have found that childhood levels of body mass index (BMI; kg/[m.sup.2]) are associated with adult levels, it has been reported that childhood BMI is not associated with adult adiposity. We further examined these longitudinal associations. Design. Cohort study based on examinations between 1973 and 1996. Setting. Bogalusa, Louisiana. Participants. Children (2610; ages 2-17 years old) who were followed to ages 18 to 37 years; the mean follow-up was 17.6 years. Main Outcome Measures. BMI-for-age and triceps skinfold thickness (SF) were measured in childhood. Subscapular and triceps SFs were measured among adults, and the mean SF was used as an adiposity index. Adult obesity was defined as a BMI [greather than or equal to] 30 kg/[m.sup.2] and adult overfat as a mean SF in the upper (gender-specific) quartile. Results. Childhood levels of both BMI and triceps SF were associated with adult levels of BMI and adiposity. The magnitude of these longitudinal associations increased with childhood age, but the BMI levels of even the youngest (ages 2-5 years) children were moderately associated (r = 0.33-0.41) with adult adiposity. Overweight (BMI-for-age [greater than or equal to] 95th centile) 2- to 5-year-olds were >4 times as likely to become overfat adults (15 of 23 [65%]), as were children with a BMI < 50th centile (30 of 201 [15%]). Even after accounting for the triceps SF of children, BMI-for-age provided additional information on adult adiposity. Conclusions. Childhood BMI is associated with adult adiposity, but it is possible that the magnitude of this association depends on the relative fatness of children. Pediatrics 2005;115:22-27; body mass index, obesity, adult adiposity, Bogalusa Heart Study, longitudinal study, skin folds., ABBREVIATIONS. BMI, body mass index; SF, skinfold thickness. Despite the limitations of weight-height indices, (1,2) they are widely used as indicators of adiposity. Several investigators have found that childhood body [...]

Guidelines for counseling obese patients are presented, based on a model developed by the National Institutes of Health. It involves assessing obesity risk, asking about readiness to lose weight, helping patients design a weight loss program, establishing an appropriate treatment, and following up on a regular basis. Obesity is a chronic condition and may require long-term treatment.

ABSTRACT This study evaluated the validity and reliability of a modified qualitative dietary fat index questionnaire (QFQ) in an adolescent minority population. The QFQ was administered to study participants twice [...]

ABSTRACT There is essentially no ideal method of dietary assessment. Physiologic methods (ie, doubly labeled water) probably come closest, but high cost, participant burden, and limited information limit their use. [...]

Traditional methods for assessing dietary behavior such as 24-hour dietary recalls, diet records, and food frequency questionnaires may not measure what we want to know about dietary behaviors of a [...]

The dairy industry spends about $225 million each year promoting its products, but historically, it has resisted explicit promotion of lowfat milk. This study examines the potential nutritional and industry benefits associated with greater use of lowfat milk by the U.S. population. The 1989 Continuing Survey of Food Intakes by Individuals (CSFII) was used to examine the association between types of milk, intake of lipids and calcium, and quantity of milk consumed. Results show that compared with whole milk drinkers, lowfat milk drinkers obtain less fat, saturated fat, and cholesterol from milk. However, lowfat milk drinkers are more likely than their counterparts to exceed the recommended levels of fat and saturated fat from all food sources. Lowfat milk drinkers consumed one-third to one-half more milk on the recalled day than whole-milk drinkers consumed. These results are consistent with other evidence that the dairy industry may derive economic benefits from promoting lowfat milk; the nutritional benefits are less clear. Additional study is warranted in this area: the effects of milk type on milk intake and dietary substitutions. Nutrition education should continue to promote specific dietary changes within the context of the total diet., For the past few decades, public-private partnerships have emerged as an important element of nutrition and public health strategies (14,17). Similarly, the Institute of Medicine has recommended the negotiation of [...]

Evaluability assessment, also commonly known as exploratory evaluadon, has assisted the field of public health to improve programs and to develop a pragmatic, practice-based research agenda. Evaluability assessment was originally developed as a low-cost pre-evaluation activity to prepare better for conventional evaluations of programs, practices, and some policies. For public health programs, however, it serves several other important purposes: (a) giving program staff rapid, constructive feedback about program operations; (b) assisting the core public health planning and assurance functions by helping to develop realistic objectives and providing low-cost, rapid feedback on implementation; (c) navigating federal performance measurement requirements; (d) translating research into practice by examining the feasibility, acceptability, and adaptation of evidence-based practices in new settings and populations; and (e) translating practice into research by identifying promising new approaches to achieve public health goals. [ABSTRACT FROM AUTHOR]

The article presents an introduction to articles published in this issue including an article on the application of Systematic Screening and Assessment (SSA) Method, another on the operation of the SSA Method as applied to the Macro Early Assessment initiative and an article on how the SSA Method has influenced the field of childhood obesity prevention.

The authors describe application of the Systematic Screening and Assessment (SSA) Method to an initiative called the Early Assessment of Programs and Policies to Prevent Childhood Obesity. Over a 2-year period, a national network of practitioners, policy makers, and funders nominated programs and policies across five substantive areas: school district local wellness policies, school-based comprehensive physical activity programs, day care and after-school programs, access to healthy foods in low-income communities, and changes in the built environment to promote physical activity. The role of an expert panel in selecting innovations for evaluability assessment on the basis of the likelihood for a positive health impact is described. © Wiley Periodicals, Inc., and the American Evaluation Association. [ABSTRACT FROM AUTHOR]

The authors present both impressions and evidence about early impacts of the Systematic Screening and Assessment (SSA) Method as applied to childhood obesity prevention. They describe how the approach has rapidly identified policy and environmental interventions that are promising and worthy of further study, contributed to field knowledge about childhood obesity prevention, and encouraged further development of specific policies and environmental interventions. The SSA Method presents a new way of identifying promising interventions from the field. By stimulating discussion of real-world application among prevention researchers, it has contributed to developing a research agenda for policy and environmental approaches to prevention. By identifying real-world applications for formal evaluation, SSA facilitates a process parallel to translation of research to practice: that is, translation of practice to research. © Wiley Periodicals, Inc., and the American Evaluation Association. [ABSTRACT FROM AUTHOR]

The article discusses a study regarding the effects of sedentary behavior, recreational physical activity and seven-year weight gain on postmenopausal U.S. women. Participants were observed for seven years by mailing them follow-up surveys to update information on their behavior and health status. Results showed that women may need to decrease the amount of time spent on sedentary behaviors and increase the time spent on recreational physical activity to reduce the risk of weight gain.