title: Patients' understanding and use of snack food package nutrition labels.
abstract: OBJECTIVE
  Little information exists on how patients in medical practice use food package nutrition labels. We theorized that patients in a general medical practice might not make the distinction between serving size and total package nutrition information, and this might lead to obesity.
  
  
  METHODS
  Ninety patients between ages of 18 and 65 attending the St. Francis/University of Tennessee Family Practice Center were interviewed to determine whether they could calculate the total calories in sample snack food packages that contained more than one serving.
  
  
  RESULTS
  Ninety percent of our patient sample correctly identified the number of calories per individual serving, but only 37% were able to recognize that the sample packages contained multiple servings. Confusion between calories per serving size and total calories per package was correlated with lower educational levels (P =.011) and with the presence of cardiovascular heart disease in our patient sample.
  
  
  CONCLUSIONS
  Our patients tended to think of a multiple serving package as one serving. They underestimated and under-reported caloric intake from snack food sources. We conclude that snack food labels as actually used by patients do not lead to informed dietary choices. These findings could impact our understanding and management of the obesity epidemic in the United States.
authors.affiliation: St. Francis Family Practice Residency Program, University of Tennessee School of Medicine, Memphis 38119, USA. apelletier@utmem.edu
authors.forename: Allen L
authors.initials: AL
authors.lastname: Pelletier
authors.forename: Wayne W
authors.initials: WW
authors.lastname: Chang
authors.forename: John E
authors.initials: JE
authors.lastname: Delzell
authors.forename: John W
authors.initials: JW
authors.lastname: McCall
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D003071:Cognition; D002149:Energy Intake; D005260:Female; D005515:Food Labeling; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000517:prevention & control; D011320:Primary Health Care; D011795:Surveys and Questionnaires