obesity, diet quality, nhanes, Consumer/Household Economics, Food Consumption/Nutrition/Food Safety, I00,

Gao, Zhifeng

Lee, Jonq-Ying

Lin, Chung-Tung Jordan

English

Research Papers in Economics

Weight Control Strategies and Diet Quality 
 
 
 
 
 
 
Chung-Tung Jordan Lin 
Center for Food Safety and Applied Nutrition, U.S. Food and Drug Administration 
(Chung-Tung.Lin@fda.hhs.gov)  
Zhifeng Gao 
Department of Food and Resource Economics, University of Florida 
(Zfgao@ufl.edu) 
Jonq-Ying Lee 
Department of Food and Resource Economics, University of Florida 
(Jonqying@ufl.edu) 
 
 
 
 
 
 
 
 
 
 
 
Poster prepared for presentation at the Agricultural & Applied Economics Association’s 2011 
AAEA & NAREA Joint Annual Meeting, Pittsburgh, Pennsylvania, July 24-26, 2011 
 
 
 
 
 
 
 
 
 
 
 
 
Copyright 2011 by Chung-Tung Jordan Lin, Zhifeng Gao and Jonq-Ying Lee.  All rights 
reserved.  Readers may make verbatim copies of this document for non-commercial purposes by 
any means, provided that this copyright notice appears on all such copies. Weight Control Strategies and Diet Quality
Chung-Tung Jordan Lin, Center for Food Safety and Applied Nutrition, U.S. Food and Drug Administration, College Park, MD 20740 
Zhifeng Gao, Department of Food and Resource Economics, University of Florida, Gainesville, FL 32306
Jonq-Ying Lee, Department of Food and Resource Economics, University of Florida, Gainesville, FL 32306
Obesity and overweight have increased over last several decades and are 
associated with non-communicable disease and mortality in the United States.  
-- In 2007-8, 34% of American adults (20 + years old) were obese (BMI 
≥
 
30) and another 34% were overweight (25 ≤
 
BMI < 30) (Flegal et al., 2010)  
-- Obesity and overweight have many health, social, psychological, and 
economic consequences.  In particular, medical expenditures attributable to 
obesity and overweight were $86 billion - $147 billion, accounting for more 
than 9% of US medical expenditures in 1998 (FDA 2011)
The Dietary Guidelines for Americans recommend people manage their 
weight by eating a healthy diet and being physically active.  Specifically, the 
2000 Guidelines recommended:
(1) choosing a healthful assortment of fruits and vegetables, grains, 
skim milk, fish, lean meat, poultry or beans low fat, low calorie foods 
(2) choosing foods low in fat and added sugars
(3) eating a sensible portion size, and
(4) being physically active  
From a public health point view, it is important that individuals do not trade 
the quality of their diet for the goal of weight management.  Otherwise, their 
overall health and economic welfare may not improve and the Nation’s 
economic burden may increase.
Previous research shows people use a variety of weight management 
strategies, some are consistent with the Guidelines and others are not (e.g., 
Weiss et al., 2006; Serdula et al., 1999).   Previous research also shows that 
different strategies are associated with different patterns of dietary intakes 
(e.g., Neumark-Sztainer et al., 2000).  Yet, there is little knowledge about how 
different weight control strategies may influence dietary quality.  
-- Hypothesis 1 is not rejected mostly; HEI of those who used one or more weight control 
methods that were not one of the recommended methods was not different from those who 
did not try to lose weight or to not gain weight
-- Hypothesis 2 is not rejected; the more recommended strategies a “controller” use, the 
higher his/her HEI is
-- These exploratory results are encouraging; yet, more detailed research needed to 
understand the complex relationships between weight control methods and dietary quality 
INTRODUCTION RESULTS
CONCLUSIONS
OBJECTIVES AND HYPOTHESES
Objectives
--  reports prevalence of weight control strategies among respondents to                                                        
the 2003-2004 National Health and Nutrition Examination Survey
--  examines influences of the use of specific weight control strategies on 
dietary quality
Hypotheses
1.  HEIs of “controllers” and “non-controllers” are differ
2.  The more recommended strategies a “controller” use, the higher his/her 
HEI is
DATA AND METHODOLOGY
Data
-- 2003-2004 National Health and nutrition Examination Survey (NHSNES) by the Centers 
for Disease Control and Prevention 
-- Study sample (N = 4,199): Respondents who were 20 + years old, were not pregnant, and 
reported two 24-hour and reliable dietary intakes
-- Group of weight control strategies:
0 = Did not report trying to lose weight or to not gain weight in the past year (“non- 
controllers”)
1 = “Controllers” who used at least one method other than the three recommended 
methods (less fat, fewer calories, and exercise)
2 = “Controllers” who used one of the three recommended methods
3 = “Controllers” who used two of the three recommended methods
4 = “Controllers” who used all three of the recommended methods (less fat, fewer 
calories, and exercise)
-- Measures of dietary quality:  USDA’s Healthy Eating group (HEI) – 2005 (USDA 2009)
-- summary score of 12 components (0 to 100)
-- each of 12 component scores (ranges vary from 0 to 5, 10, or 20)
Econometric Models
Weighted LS regression of summary HEI, weighted two-limit Tobit regression of each 
component HEIs
Controlled for demographics, life styles, other dietary behaviors, body weight perceptions
HEI score ( min – max) Group 1 Group 2 Group 3 Group 4
Summary ( 0 – 100 ) n.s. 1.86 *            2.87 * 4.80 *
Total fruit ( 0 -5 ) n.s. 0.18 ** 0.37 * 0.68 *
Whole fruit ( 0 – 5 ) n.s. 0.34 * 0.59 * 1.30 *
Total vegetables ( 0 – 5 ) n.s. n.s. 0.16 ** 0.30 *
Dark green & orange 
vegetables, legumes ( 0 – 5 )
n.s. n.s. n.s. 0.49 *
Total grains ( 0 – 5 ) n.s. n.s. n.s. 0.21 *
Whole grains ( 0 – 5 ) 0.17 ** 0.44 * 0.67 * 0.60 *
Milk ( 0 – 10 ) n.s. 0.31 * 0.46 * 0.36 **
Meat and beans ( 0 – 10 ) n.s. -0 . 2 4  * * n.s. n.s.
Oils ( 0 – 10 ) n.s. n.s. n.s. n.s.
Saturated fat ( 0 – 10 ) n.s. 0.33 * 0.60 * 0.70 *
Sodium ( 0 – 10 ) n.s. n.s. n.s. -0 . 6 0  *
SoFAAS ( 0 – 20 ) n.s. 0.91 * 1.67 * 2.61 *
Regression Estimates – Groups of Controllers Relative to Non-controllers 
REFERENCES
Flegal, K.M., et al. (2000).  JAMA 303(3): 235-241.  
FDA. (2011).  Federal Register 76(66): 19192-19236.
Neumark-Sztainer, et al. (2000).  Preventive Medicine 30: 381-391.
Serdula, M.K., et al. (1999).  JAMA 282(14): 1353-8.
USDA. (2009). Healthy Eating Index.  http://www.cnpp.usda.gov/HealthyEatingIndexSupportFiles0304.htm.
Weiss, E.C., et al. (2006).  American Journal of Preventive Medicine 31(1): 18-24.
51.9 52 54.2 55.2 57.5
0
20
40
60
80
100
Group 0 Group 1 Group 2 Group 3 Group 4
Group 0 = no weight control (50% of respondents);    Group 1 = used ≥
 
1 non-recommended methods (10%);
Group 2 = used 1 of 3 recommended methods (23%); Group 3 = used 2 of 3 recommended methods (8%);
Group 4 = used only all 3 recommended methods (9%)
Summary HEI
2.3 2.3 2.4 2.5
2.8
0
1
2
3
4
5
Group
0
Group
1
Group
2
Group
3
Group
4
Total fruits
2 2
2.2 2.3
2.7
0
1
2
3
4
5
Group
0
Group
1
Group
2
Group
3
Group
4
Whole fruit
3 3
3.2 3.3 3.5
0
1
2
3
4
5
Group
0
Group
1
Group
2
Group
3
Group
4
Total vegetables
1.2 1.2 1.3 1.4
1.7
0
1
2
3
4
5
Group
0
Group
1
Group
2
Group
3
Group
4
Color vegetables
4.2 4.2 4.2 4.2 4.3
0
1
2
3
4
5
Group
0
Group
1
Group
2
Group
3
Group
4 Total grains
1 1
1.2 1.3 1.3
0
1
2
3
4
5
Group
0
Group
1
Group
2
Group
3
Group
4
Whole grains
Milk
4.5 4.5 4.8 4.9 5
0
2
4
6
8
10
Group
0
Group
1
Group
2
Group
3
Group
4
8.4 8.3 8.3 8.4 8.5
0
2
4
6
8
10
Group
0
Group
1
Group
2
Group
3
Group
4 Meat and beans
5.4 5.6 5.7 5.5 5.7
0
2
4
6
8
10
Group
0
Group
1
Group
2
Group
3
Group
4
Oils
6 5.8 6 6.3 6.3
0
2
4
6
8
10
Group
0
Group
1
Group
2
Group
3
Group
4
Saturated fat
4.2 4 4 3.9
3.5
0
2
4
6
8
10
Group
0
Group
1
Group
2
Group
3
Group
4
Sodium
9.6 10 10.7 11.1
12.2
0
5
10
15
20
Group
0
Group
1
Group
2
Group
3
Group
4
Calories from solid fats,
alc bev, added sugars
* α
 
< 0.001,  ** α
 
< 0.05,  *** α
 
< 0.10
Component HEIs

Healthy Eating Index.

weight control (50% of respondents); Group 1 = used ≥ 1 non-recommended methods (10%); Group 2 = used 1 of 3 recommended methods (23%); Group 3 = used 2 of 3 recommended methods (8%); Group 4 = used only all 3 recommended methods (9%) Summary

Weight Control Strategies and Diet Quality

Abstract

Similar works

Full text

Available Versions

Research Papers in Economics