Attitudes and behaviors related to weight status

Food Review, Jan-April, 1994 by Donald Rose

The Dietary Guideline to maintain a healthy weight may be one of the most difficult to meet. This guideline is not new--having appeared as a recommendation in Government publications for close to 15 years. But despite public investment in health education and new evidence which shows that a majority of Americans are aware of health problems associated with being overweight, the percentage of overweight people in the United States is actually increasing.

Information from two recent national surveys--the 1989-90 Diet and Health Knowledge Survey (DHKS) and the Continuing Survey of Food Intakes by Individuals (CSFII)--reveals some interesting insights into the awareness, attitudes, and behaviors about food intake, weight maintenance, and related nutrition and health issues. These are the first national surveys to gather this information as well as food consumption data from the same individual.

For the surveys, conducted by USDA's Human Nutrition Information Service, a nationally representative sample of people was selected and asked to provide 3 days of food intake information. In addition, the main meal planners/preparers for the household answered questions about their weight and their attitudes and knowledge about diet and health. The sample used for this article consisted of 2,232 women who were not pregnant or breastfeeding. (For additional information about these surveys, see the inside front cover of this issue.)

The surveys support what nutritionists have known for some time that awareness of the relationship between diet and health may not be enough to change behavior effectively. In fact, the survey found that among women, awareness of health problems associated with being overweight did not lessen the likelihood of being overweight.

However, women who value the importance of maintaining a desirable weight appear less likely to be overweight than are those who do not possess this attitude. These women are also more likely to engage in moderate to heavy physical activity during leisure time, which may partly explain the association with weight status.

More Are Overweight Today Than in the 1970's

In Healthy People 2000, the Nation's health professionals set a goal of reducing the percentage of people who are overweight by more than 20 percent of the rate in the late 1970's. This goal seems ambitious, especially in light of recent trends. Self-reported weight and height data from women responding to the 1989-90 CSFII surveys reveal that 30 percent of those aged 20-74 years are overweight. This is slightly higher than the 27 percent of women of the same age who were found to be overweight in the 1976-80 National Health and Nutrition Examination Survey (NHANES), which weighed respondents.

Although the surveys are not directly comparable, it appears that the percentage of overweight women is increasing. Preliminary data from phase I of the third NHANES (1988-91) show that a greater percentage (35 percent) of women are overweight today than in the late 1970's.

As has been found in other surveys, the CSFII shows that a larger percentage of low-income women are overweight than are high-in-come women. Likewise, weight status is similarly associated with education level. For example, women with 8 years or less of education are more likely to be overweight than are those who have more schooling.

A higher percentage of black women are overweight than white women in all age

groups. The prevalence is particularly high--52 percent--for black women in their 30's and 40's.

Table 1
Being Overweight Is a Condition Which Cuts Across Economic, Educational, and
Racial Lines

                                                          Aware of
Respondent profile                  Overweight(1)    weight-health link(2)

                                        Percent of women meal planners

Age:
Under 30 years                          12                   70
30-49 years                             30                   81
50 years and over                       34                   71

Race:
White                                   27                   76
Black                                   46                   75

Income level
(percent of poverty line):(3)
185 percent and under                   30                   68
186-350 percent                         35                   73
Over 350 percent                        24                   82

Education (years of schooling):
8 years or less                         37                   57
9-11 years                              30                   68
12 years                                29                   78
Over 12 years                           26                   79

Notes: 1 For women, overweight is defined as a body mass index (BMI) of 27.3
or greater. BMI is a ratio of weight (in kilograms) divided by the square of
height (in meters).

2 Women were considered "aware" of the weight-health link if they identified
diabetes, hypertension, heart disease, or some cancers as a health problem
that might be related to being overweight.

3 The poverty line is a set of income thresholds used by the Bureau of Census
to determine poverty status of households. The thresholds--which vary by
family size, age of household head, and number of children under 18 years of
age--are updated annually to reflect inflation. In 1989, for example, the
average poverty threshold for a household of four was $11,669.