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In this essay based on research for her book, Aging: Demographics, Health, and Health Services (Greenwood Press), market research consultant Kris Hodges analyzes data from the Diet and Health Knowledge Survey to draw a portrait of American eating habits and the demographics of nutrition in this country. Although the DHKS was last conducted in 1994-1996, Hodges' analysis provides new insights into Americans' dietary self-perceptions. Nearly 6,000 adults age 20 and older participated in the DHKS, a subset of the USDA's nationwide Continuing Survey of Food Intakes by Individuals. They were asked the importance of various dietary aspects, ranging from fat, sodium and cholesterol intake to fiber and calcium consumption, as well as the impressions of their diet on these aspects. Survey responses were then related to the respondent's actual food intake. As Hodges explains, the results of the survey are important in weighing the future of America's physical health.


Obesity is literally becoming a bigger problem in America and not only are the added health risks substantial, but many Americans aren't even aware they're part of the problem. Newly released data from the National Health and Nutrition Examination Survey shows that today's adults ages 20 to 74 are twice as likely to be obese than adults in the late 1970s (31 percent in 1999-2000 versus 15 percent in 1976-1980).

Considering the imperfect state of their health, Americans seem strangely confident about their eating habits, with 54 percent believing their diets are healthy enough that there is no reason for them to change. But according to the USDA's extensive Diet and Health Knowledge Survey (DHKS), major misperceptions lie in the areas of fat and calorie intake, and weight. For example, Americans place the greatest importance on maintaining a healthy weight with 73 percent saying that aspect is “very important� to them. Women of all ages place greater importance than men on maintaining a healthy weight. But, even among those respondents placing the most importance on maintaining a healthy weight, 26 percent are either overweight or obese by government standards. Despite their higher commitment, this group is just as likely to be overweight or obese as the people who place the least importance on maintaining a healthy weight.

Americans — especially men and black women — are not always the best judges of their own weight status: 45 percent of men and 48 percent of black women believe their weight is “about right� but are technically overweight or obese (compared with 12 percent of white women). Nearly 1 in 4 Americans (23 percent) is over-confident of their caloric intake, believing the number of calories they consume is about right, while in reality they're overweight or obese. Men of all ages are substantially more over-confident than women, and older Americans are more over-confident than younger people.

Americans also place great importance on consuming a low-fat diet with 58 percent stating it is very important to them. These more motivated people consume fat at levels about 10 percent to 15 percent lower than their less motivated counterparts. Yet, 27 percent are mistaken about their fat intake. Except for older Americans (age 60 and older), men are more over-confident than women.

The message that high cholesterol levels are a risk factor for heart disease and stroke appears to have been heard, and is reflected in consumption statistics, serum cholesterol levels and DHKS data. USDA statistics indicate that between 1980 and 1999 fresh egg consumption declined 23 percent, whole milk consumption declined by 50 percent and the consumption of skim milk more than doubled. Not surprisingly, the proportion of today's adults with high serum cholesterol levels is more than one-third lower than it was in the early 1960s. According to the DHKS, a diet low in cholesterol is very important to 56 percent of Americans. Average daily cholesterol consumption is 24 percent lower among these most motivated people compared with the least motivated Americans. Still, while people are most realistic about cholesterol consumption, about 1 in 5 is over-confident, with men more over-confident than women (23 percent compared with 13 percent).

The DHKS indicates that 8 in 10 Americans realize that “choosing a healthy diet is just a matter of knowing what foods are good and what foods are bad.� However, the same percentage also say “There are so many recommendations about healthy ways to eat, it's hard to know what to believe.� And 41 percent of Americans believe “some people are born to be fat and some thin; there is not much you can do to change this.� Are Americans just confused and throwing caution to the wind? Or are we becoming more resigned to a heavier weight status?

Our weight-obsessed society abounds with weight-loss contraptions, pills, programs and their associated advertising campaigns; media images of thin people are ubiquitous. At the same time, restaurants offer mega-size portions and we respond. Given the burgeoning American waistline, everyone needs to become more aware of what constitutes excessive weight. While people can make dietary changes, further efforts can influence additional improvements. Food producers and purveyors can provide healthier products, as processed foods and restaurant meals provide much of our dietary caloric and nutritional intake. Not only do Americans need to exercise more restraint, companies can exercise more options to help us do so.

Kris Hodges can be reached at [email protected]. Her book is available at or by calling (800) 225-5800.

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