Health Disparities in Calorie Knowledge and Confidence Among the U.S. Adult Population

Abstract

Purpose Obesity prevalence has reached an all-time high in the US, affecting >40% of the population. This study’s objective was to evaluate associations between demographics and self-reported calorie knowledge and self-perceived confidence in calorie knowledge (“calorie confidence”). The relationships between body mass index (BMI) and calorie knowledge and confidence were also explored. Methods We analyzed data from participants (n = 2171) in the crosssectional, nationally representative 2019 FDA Food Safety and Nutrition Survey using logistic regression to estimate adjusted odds ratios (AORs) and confidence intervals (95% CIs) for associations between BMI and calorie knowledge (correct/incorrect), calorie confidence (confident/not confident), and demographic characteristics, and the Wald chi square test to evaluate relationships between BMI and both calorie knowledge and confidence. Results Many of the same subgroups were more likely than others to report lack of calorie knowledge and lack of confidence in knowing the typical daily calorie intake needed to maintain a healthy weight [respective AORs (95% CIs): age (years), >60 vs 51-60, 1.7 (1.1-2.5), and 1.4 (1.0-2.0); sex, male vs female, 1.7 (1.3-2.3), and 1.7 (1.3-2.1); race/ethnicity, non-Hispanic Black vs non-Hispanic white, 3.4 (2.1-5.5), and 2.4 (1.6-3.8); education, ≤high school vs college grad, 1.5 (1.0- 2.3), and 1.9 (1.3-2.7)]. BMI was significantly correlated with calorie confidence ( P = .047), such that those reporting less confidence were more likely overweight or obese [underweight/healthy (BMI < 25): 29%, overweight (25 ≤ BMI < 30): 34%, obese (BMI ≥ 30): 37%]. Conclusion In certain demographic subgroups associations between calorie knowledge and confidence differed. Tailored education and outreach for these groups may help to address these disparities.

Knowledge of calories and its influencing factors: evidence from a fast-growing developing country

“…Less than 20% of respondents with no formal or primary-level education understood the effect of calories on body weight, and only less than 5% knew about daily caloric recommendations. These outcomes were consistent with evidence from previous studies that individuals with higher educational levels were more likely to know about recommended caloric intake and understand nutrition labels when compared to those with lower educational levels (Bleich and Pollack, 2010;Campos et al, 2011;Sinclair et al, 2013;McCrory et al, 2016;McKinnon et al, 2019;Lando et al, 2021). There are two plausible explanations for these findings.…”

“…Ethnic differences in nutrition knowledge were evident in previous US studies. Lando et al (2021) found that non-Hispanic Blacks had poorer caloric knowledge compared with non-Hispanic Whites. The findings of McKinnon et al (2019) also demonstrated that cultural status as Hispanic or non-Hispanic Blacks was correlated with a poor understanding of caloric requirements.…”

“…Ethnic differences in nutrition knowledge were evident in previous US studies. Lando et al. (2021) found that non-Hispanic Blacks had poorer caloric knowledge compared with non-Hispanic Whites.…”

“…In the US and Canada, older people were found to be less likely to know about required caloric intake than younger people (McCrory et al. , 2016; Lando et al. , 2021).…”

“…A study in Canada found that males were less likely to know about recommended caloric intake than females (McCrory et al, 2016). Using the US data, Lando et al (2021) also found that men had a lower likelihood of understanding caloric needs compared with women. Similar outcomes were reported by Krukowski et al (2006) and McKinnon et al (2019).…”