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Obesity and weight control
since the students showed enthusiasm for the learning activities. This study demonstrated that elementary teachers, when assisted by a nutrition resource person, are able to teach nutrition successfully in their grades. 0
3 4 5
ACKNOWLEDGMENT
The contributions and cooperation of the fourth grade teachers, Reve Trowbridge, Beverly Accola, and Maxine Phillips; of the foodservice manager, Marge Skogstad, and foodservice workers; and of James Harrison, principal of Mondovi, Wisconsin, Elementary School are acknowledged gratefully. This research was conducted as a graduate thesis project in the Food and Nutrition Department, School of Home Economics, University of Wisconsin-Stout. LITERATURE CITED
Congress passes nutrition education bill (Editorial insert). Journal of Nutrition Education 9:168A-68D, 1977. 2 American Dietetic Association. Position paper on the scope and
6 7 8 9 10
thrust of nutrition education. Journal ofthe American Dietetic Association 72:302-5, 1978. U.S. Senate. Select Committee on Nutrition and Human Needs. Dietary goals for the United States. 2d ed. Washington, D.C.: Government Printing Office, 1977. Poolton, M. A. What can we do about food habits? Journal of School Health 48:646-48, 1978. U.S. White House. White House Conference on Food, Nutrition, and Health: Final report. Washington, D.C.: Government Printing Office, 1969, p. 155. Gifft, H. H., M. B. Washbon, and G. G. Harrison. Nutrition, behavior, and change. Englewood Cliffs, N.J.: Prentice-Hall, 1973, pp. 228-31. U.S. Department of Agriculture. Food for fitness, A daily food guide. Rev. ed. Washington, D.C.: Government Printing Office, 1967. Bell, C. G., and M. W. Lamb. Nutrition education and dietary behavior of fifth graders. Journal of Nutrition Education 5:196-99, 1973. Blalock, H. M. Social statistics. New York: McGraw-Hill Book Co., 1960, pp. 176-78,441. Blalock, H. M. Social statistics. New York: McGraw-Hill Book Co., 1960, pp. 144-49, 442.
OBESITY AND WEIGHT CONTROL A critical and analytical review article by R. R. Wing and R. W. Jeffrey (International Journal of Obesity 3:261-79,1979) provides a valuable update of the weight reduction methodology and effectiveness literature. The authors have taken the same general approach as taken in the classic contribution of A. J. Stunkard and M. McLaren-Hume (Archives of Internal Medicine 103:7985, 1959) and have summarized and analyzed the (1966-77) literature on weight reduction programs. They included the results of 145 articles on outpatient weight reduction efforts that provide sufficient data to calculate the average weight loss of five adult clients. They assigned each report to one offour major categories-drugs, behavior therapy, exercise, or diet - with some further subdivisions and summarized, insofar as was possible, the average total weight loss, average weekly weight loss, percentage losing more than 20 pounds, and change in weight at follow-up. The discouraging news is that those investigators reporting effectiveness of weight loss programs are not doing much better with respect to detailing methodology or with respect to apparent effectiveness than was the case 20 years ago. Many seemingly obvious and critical characteristics of the program were omitted by many investigators. Only 690/0 reported pretreatment weight; less than 40010 mentioned characteristics of the therapist; even the number of subjects completing treatment was only reported by 88%. Fewer than 30% of the studies reported duration of patient-therapist contact, cost, or any followup data. Only 8% reported weight loss of dropouts, and a mere 6% of the studies provided follow-up data for one year or more. Also disappointing was the fact that, overall, the 145 studies averaged only about 12 pounds weight loss per subject; since, as far as could be determined, the average subject was about 50 pounds overweight, this result indicates very limited success. VOLUME
12
NUMBER
2
1980
The good news for dietitians and other nutntlOn educators involved with weight control programs is that diet alone averaged 18 pounds weight loss per subject and is as effective without drugs as with. Behavior modification techniques appear somewhat less effective for initial weight loss but are more effective than other programs in preventing weight regain. However, reporting of followup data is quite inadequate for other approaches. Good suggestions are given in this report for designing and reporting results of weight reduction programs. Hopefully this review will be better heeded by investigators in this field than were similar admonitions offered in its predecessor by Stunkard and McLaren-Hume.
o A wealth of useful statistics related to the estimated incidence of and the trends in overweight and obesity in the United States by age and sex is provided in Advancedata (51: 1-9, August 30, 1979), a publication of the National Center for Health Statistics, 3700 East-West Highway, Hyattsville, MD 20782. Copies can be obtained by writing or by calling 301-436-6247 and requesting DHEW publication no. (PHS)79-1250. The data are based on the 1971-74 Health and Nutrition Examination Survey (HANES) in which a sample of over 13,000 persons representative ofthe adult civilian noninstitutionalized population of the United States was examined. Average heights, weights, body mass indices (relating weight to height), and skinfold thickness for men and women in several age categories are presented for persons 10% or more and 20% or more over desirable weight. Also, the HANES data are compared with the 1960-62 Health Examination Survey (HES) data with respect to the distribution of persons among percentage of desirable weight categories. 8.M.O. JOURNAL OF NUTRITION EDUCATION
49
3 4 5
ACKNOWLEDGMENT
The contributions and cooperation of the fourth grade teachers, Reve Trowbridge, Beverly Accola, and Maxine Phillips; of the foodservice manager, Marge Skogstad, and foodservice workers; and of James Harrison, principal of Mondovi, Wisconsin, Elementary School are acknowledged gratefully. This research was conducted as a graduate thesis project in the Food and Nutrition Department, School of Home Economics, University of Wisconsin-Stout. LITERATURE CITED
Congress passes nutrition education bill (Editorial insert). Journal of Nutrition Education 9:168A-68D, 1977. 2 American Dietetic Association. Position paper on the scope and
6 7 8 9 10
thrust of nutrition education. Journal ofthe American Dietetic Association 72:302-5, 1978. U.S. Senate. Select Committee on Nutrition and Human Needs. Dietary goals for the United States. 2d ed. Washington, D.C.: Government Printing Office, 1977. Poolton, M. A. What can we do about food habits? Journal of School Health 48:646-48, 1978. U.S. White House. White House Conference on Food, Nutrition, and Health: Final report. Washington, D.C.: Government Printing Office, 1969, p. 155. Gifft, H. H., M. B. Washbon, and G. G. Harrison. Nutrition, behavior, and change. Englewood Cliffs, N.J.: Prentice-Hall, 1973, pp. 228-31. U.S. Department of Agriculture. Food for fitness, A daily food guide. Rev. ed. Washington, D.C.: Government Printing Office, 1967. Bell, C. G., and M. W. Lamb. Nutrition education and dietary behavior of fifth graders. Journal of Nutrition Education 5:196-99, 1973. Blalock, H. M. Social statistics. New York: McGraw-Hill Book Co., 1960, pp. 176-78,441. Blalock, H. M. Social statistics. New York: McGraw-Hill Book Co., 1960, pp. 144-49, 442.
OBESITY AND WEIGHT CONTROL A critical and analytical review article by R. R. Wing and R. W. Jeffrey (International Journal of Obesity 3:261-79,1979) provides a valuable update of the weight reduction methodology and effectiveness literature. The authors have taken the same general approach as taken in the classic contribution of A. J. Stunkard and M. McLaren-Hume (Archives of Internal Medicine 103:7985, 1959) and have summarized and analyzed the (1966-77) literature on weight reduction programs. They included the results of 145 articles on outpatient weight reduction efforts that provide sufficient data to calculate the average weight loss of five adult clients. They assigned each report to one offour major categories-drugs, behavior therapy, exercise, or diet - with some further subdivisions and summarized, insofar as was possible, the average total weight loss, average weekly weight loss, percentage losing more than 20 pounds, and change in weight at follow-up. The discouraging news is that those investigators reporting effectiveness of weight loss programs are not doing much better with respect to detailing methodology or with respect to apparent effectiveness than was the case 20 years ago. Many seemingly obvious and critical characteristics of the program were omitted by many investigators. Only 690/0 reported pretreatment weight; less than 40010 mentioned characteristics of the therapist; even the number of subjects completing treatment was only reported by 88%. Fewer than 30% of the studies reported duration of patient-therapist contact, cost, or any followup data. Only 8% reported weight loss of dropouts, and a mere 6% of the studies provided follow-up data for one year or more. Also disappointing was the fact that, overall, the 145 studies averaged only about 12 pounds weight loss per subject; since, as far as could be determined, the average subject was about 50 pounds overweight, this result indicates very limited success. VOLUME
12
NUMBER
2
1980
The good news for dietitians and other nutntlOn educators involved with weight control programs is that diet alone averaged 18 pounds weight loss per subject and is as effective without drugs as with. Behavior modification techniques appear somewhat less effective for initial weight loss but are more effective than other programs in preventing weight regain. However, reporting of followup data is quite inadequate for other approaches. Good suggestions are given in this report for designing and reporting results of weight reduction programs. Hopefully this review will be better heeded by investigators in this field than were similar admonitions offered in its predecessor by Stunkard and McLaren-Hume.
o A wealth of useful statistics related to the estimated incidence of and the trends in overweight and obesity in the United States by age and sex is provided in Advancedata (51: 1-9, August 30, 1979), a publication of the National Center for Health Statistics, 3700 East-West Highway, Hyattsville, MD 20782. Copies can be obtained by writing or by calling 301-436-6247 and requesting DHEW publication no. (PHS)79-1250. The data are based on the 1971-74 Health and Nutrition Examination Survey (HANES) in which a sample of over 13,000 persons representative ofthe adult civilian noninstitutionalized population of the United States was examined. Average heights, weights, body mass indices (relating weight to height), and skinfold thickness for men and women in several age categories are presented for persons 10% or more and 20% or more over desirable weight. Also, the HANES data are compared with the 1960-62 Health Examination Survey (HES) data with respect to the distribution of persons among percentage of desirable weight categories. 8.M.O. JOURNAL OF NUTRITION EDUCATION
49