title: Improving literacy about energy-related issues: the need for a better understanding of the concepts behind energy intake and expenditure among adolescents and their parents.
abstract: Despite the need for effective obesity prevention strategies, little research has assessed adolescents' knowledge about basic concepts of energy intake, expenditure, and balance. Using data from 349 adolescent-caregiver pairs (recruited from Minneapolis/St Paul, MN metro region, 2006-2007), cross-sectional linear regression was used to assess adolescent and parental knowledge related to energy intake and expenditure as a predictor of adolescent weight-related behaviors and outcomes. Findings indicated that knowledge related to energy intake and expenditure was highly variable, with a substantial proportion of participants (particularly adolescents) lacking knowledge on a range of concepts. Adolescent knowledge was positively associated with moderate physical activity and negatively associated with television viewing (P<0.05), but it was not associated with sweetened beverage consumption, fast food intake, weight status, and/or body composition. Although overall parental knowledge was a significant predictor of adolescent knowledge (P<0.01), parent-child agreement on individual items was poor. As adolescents age, low literacy in this area may set the stage for poor decision-making related to energy balance and healthy weight maintenance. However, in that knowledge was not a significant predictor of various weight-related outcomes, these and other findings suggest that purely education-based health promotion strategies are insufficient to initiate long-term healthful behavior change. Educational strategies may be effective when combined with those also targeting familial, social, and environmental influences. The examination of interactive effects between individual-level and environmental influences on health behavior is an important area for future obesity-related research.
authors.affiliation: Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN 55454-1015, USA. nels5024@umn.edu
authors.forename: Melissa C
authors.initials: MC
authors.lastname: Nelson
authors.forename: Leslie A
authors.initials: LA
authors.lastname: Lytle
authors.forename: Keryn E
authors.initials: KE
authors.lastname: Pasch
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D053198:Child Nutrition Sciences / Q000193:education*; D003430:Cross-Sectional Studies; D002149:Energy Intake / Q000502:physiology*; D004734:Energy Metabolism / Q000502:physiology*; D015444:Exercise / Q000502:physiology; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000379:methods; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000517:prevention & control* / Q000523:psychology; D010290:Parents / Q000193:education* / Q000523:psychology; D013690:Television