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Recommendations Summary

Adult Weight Management (AWM) Nutrition Education

Click here to see the explanation of recommendation ratings (Strong, Fair, Weak, Consensus, Insufficient Evidence) and labels (Imperative or Conditional). To see more detail on the evidence from which the following recommendations were drawn, use the hyperlinks in the Supporting Evidence Section below.

• Recommendation(s)

  AWM: Nutrition Education

  Nutrition education should be individualized and included as part of the diet component of a comprehensive weight management program. Short term studies show that nutrition education (e.g. reading nutrition labels, recipe modification, cooking classes) increases knowledge and may lead to improved food choices.

  Rating: Fair
  Imperative

  • Risks/Harms of Implementing This Recommendation

    None.

  • Conditions of Application

    No conditions specified.

  • Potential Costs Associated with Application

    None.

  • Recommendation Narrative

    • One positive-quality RCT, one positive-quality cohort, and one neutral-quality cross-sectional study demonstrate successful behavior change and improved eating habits based on interventions involving cooking classes (Keller et al, 2004; Masley et al, 2001; Newman et al, 2005)  
    • Three cross-sectional studies (1 positive-quality, 2 neutral-quality) report that cooking classes are a highly requested nutrition education program enhancement (Birkett et al, 2004; Cavallaro et al, 2004; Keller-Olaman et al, 2005) 
    • Eight cross-sectional studies (3 positive-quality, 5 neutral-quality) report that as many as 80% of healthy people read nutrition information on food labels usually or often, and women generally read labels more than men (Kristal et al, 1998; Lin et al, 2004; Macon et al, 2004; Marietta et al, 1999; Neuhouser et al, 1999; Perez-Escamilla and Haldeman,  2002; Satia et al, 2005; Smith et al, 2000)  
    • Two neutral-quality RCTs and three nonrandomized clinical trials (1 positive-quality and 2 neutral-quality) show conflicting results about the effect of nutrition information on food choices; in three trials, subjects used nutrition information in product selection, while in 2 trials, there were no significant differences in food consumption (Bushman, 1998; Kral et al, 2002; Miller et al, 1999; Roefs and Jansen, 2004; Westcombe and Wardle, 1997)

  • Recommendation Strength Rationale

    • Conclusion statements both given a Grade III

  • Minority Opinions

    Consensus reached.

• Supporting Evidence

  The recommendations were created from the evidence analysis on the following questions. To see detail of the evidence analysis, click the blue hyperlinks below (recommendations rated consensus will not have supporting evidence linked).

  In adults, do interventions focused on healthy cooking techniques (including recipe modification) result in improved eating habits?
  
  In adults, what is the relationship between reading nutrition information (including Nutrition Facts on the food label) and selecting healthier food choices?

  • References

    Birkett D, Johnson D, Thompson JR, Oberg D. Reaching low-income families: focus group results provide direction for a behavioral approach to WIC services. J Am Diet Assoc, 2004; 104: 1277-1280.
    
    Capps O, Cleveland L, Park J. Dietary behaviors associated with total fat and saturated fat intake.  J Am Diet Assoc 2002; 102: 490-496, 501-502.
    
    Cavallaro V, Dwyer J, Houser RF, Shores K, Canez I, Hong A, Altman K, Helmick E, Murphy JN. Influence of dietitian presence on outpatient cardiac rehabilitation nutrition services. J Am Diet Assoc, 2004; 104: 611-614.
    
    Keller HH, Gibbs A, Wong S, Vanderkooy P, Hedley M.  Men can cook!  Development, implementation, and evaluation of a senior men's cooking group.  J Nutr Elderly 2004; 24(1): 71-87.
    
    Keller-Olaman SJ, Edwards V, Elliott SJ.  Evaluating a food bank recipe-tasting program.  Can J Diet Pract Res 2005; 66: 183-186.
    
    Masley S, Phillips S, Copeland JR.  Group office visits change dietary habits of patients with coronary artery disease:  the dietary intervention and evaluation trial (DIET).  J Fam Pract 2001; 50: 235-239.
    
    Newman VA, Thomson CA, Rock CL, Flatt SW, Kealey S, Bardwell WA, Caan BJ, Pierce JP, for the Women's Healthy Eating and Living (WHEL) Study Group.  Achieving substantial changes in eating behavior among women previously treated for breast cancer - an overview of the intervention.  J Am Diet Assoc 2005; 105: 382-391.
    
    Bushman BJ.  Effects of warning and information labels on consumption of full-fat, reduced-fat and no-fat products.  J Appl Psychol 1998; 83(1): 97-101.
    
    Kessler H, Wunderlich SM.  Relationship between use of food labels and nutrition knowledge of people with diabetes.  Diabetes Educ 1999; 25(4): 549-559.
    
    Kral TVE, Roe LS, Rolls BJ.  Does nutrition information about the energy density of meals affect food intake in normal-weight women?  Appetite 2002; 39(2): 137-145.
    
    Kreuter MW, Brennan LK, Scharff DP, Lukwago SN.  Do nutrition label readers eat healthier diets?  Behavioral correlates of adults' use of food labels.  Am J Prev Med 1997; 13(4): 277-283. 
    
    Kristal AR, Levy L, Patterson RE, Li SS, White E.  Trends in food label use associated with new nutrition labeling regulations.  Am J Public Health 1998; 88(8): 1212-1215.
    
    Lin CTJ, Lee JY, Yen ST.  Do dietary intakes affect search for nutrient information on food labels?  Soc Sci Med 2004; 59(9): 1955-1967.
    
    Macon JF, Oakland MJ, Jensen HH, Kissack PA.  Food label use by older Americans:  data from the Continuing Survey of Food Intakes by Individuals and the Diet and Health Knowledge Survey 1994-1996.  J Nutr Elder 2004; 24(1): 35-52.
    
    Marietta AB, Welshimer KJ, Anderson SL.  Knowledge, attitudes, and behaviors of college students regarding the 1990 Nutrition Labeling Education Act food labels.  J Am Diet Assoc 1999; 99: 445-449.
    
    Miller CK, Jensen GL, Achterberg CL.  Evaluation of a food label nutrition intervention for women with type 2 diabetes mellitus.  J Am Diet Assoc 1999; 99(3): 323-328.
    
    Miller CK, Probart CK, Achterberg CL.  Knowledge and misconceptions about the food label among women with non-insulin-dependent diabetes mellitus.  Diabetes Educ 1997; 23(4): 425-432.
    
    Neuhouser ML, Kristal AR, Patterson RE.  Use of food nutrition labels is associated with lower fat intake.  J Am Diet Assoc 1999; 99: 45-50, 53.
    
    Perez-Escamilla R, Haldeman L.  Food label use modifies association of income with dietary quality.  J Nutr 2002; 132: 768-772.
    
    Roefs A, Jansen A.  The effect of information about fat content on food consumption in overweight/obese and lean people.  Appetite 2004; 43: 319-322. 
    
    Satia JA, Galanko JA, Neuhouser ML.  Food nutrition label use is associated with demographic, behavioral, and pyschosocial factors and dietary intake among African Americans in North Carolina.  J Am Diet Assoc 2005; 105: 392-402.
    
    Smith SC, Taylor JG, Stephen AM.  Use of food labels and beliefs about diet-disease relationships among university students.  Public Health Nutr 2000; 3(2): 175-182.
    
    Westcombe A, Wardle J.  Influence of relative fat content information on responses to three foods.  Appetite 1997; 28: 49 - 62.