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Confusion on All Sides of the Calorie Equation: Lessons Learned, Future Directions

Kapsak, Wendy Reinhardt MS, RD; DiMarco-Crook, Christina MS; Hill, James O. PhD; Toner, Cheryl D. MS, RDN; Edge, Marianne Smith MS, RD, LD, FADA

doi: 10.1097/NT.0b013e3182a68476
1.5 CPEUs and 2.3 ANCC Contact Hours

The high prevalence of overweight and obesity in the United States has increased attention to the importance of balancing calories in and out to achieve and maintain a healthy weight. Numerous policy and educational efforts are aimed at helping consumers achieve calorie balance. Still, a calorie disconnect exists as consumers remain largely unaware of personal calorie needs or the relationship between calories and weight management. A key first step in addressing consumers’ calorie confusion may be to familiarize them with their “daily calorie number,” or the amount of calories that are needed to maintain weight, and how that daily calorie number is impacted by physical activity. The need to individualize calorie balance communications is essential, as each person has a unique weight management profile that will be impacted by many factors, including age, physical activity, and desired weight outcome. Whereas some Americans would like to maintain weight and prevent further weight gain, many others would likely benefit from tipping the calorie balance equation to achieve successful weight loss. To effectively communicate calorie balance, it is imperative to examine consumer response to calorie balance communications. Some messages or terminology, although widely accepted by nutrition and health professionals, may not be understood by consumers. The social-ecological model is a useful framework to further examine factors that impact behavior change related to food and physical activity decisions, providing opportunities for future research and initiatives aimed at helping consumers achieve calorie balance.

Experts on communications and experts on the science weigh in on how best to clarify some of the confusion about calories.

Wendy Reinhardt Kapsak, MS, RD, is currently senior manager of public affairs at the Monsanto Company in St. Louis, Missouri, where she specializes in food and nutrition communications and health professional outreach. At the time the work and corresponding manuscript were completed, Wendy was senior director of health and wellness at the International Food Information Council Foundation in Washington, DC, where she specialized in consumer research and communications on a variety of food safety and nutrition issues.

Christina DiMarco-Crook, MS, a US Department of Agriculture Fellow, is a PhD candidate at the University of Massachusetts, Amherst. She currently conducts research at the Fergus M. Clydesdale Center for Foods for Health & Wellness, examining the health-promoting effects of bioactive food components.

James O. Hill, PhD, a renowned leader in the fight against the global obesity epidemic, is executive director of the Anschutz Health and Wellness Center, University of Colorado, Aurora. Dr Hill is cofounder of the National Weight Control Registry, a catalogue of individuals who have been successful in maintenance of a reduced body weight. He is also cofounder of America on the Move, which aims to inspire Americans to make small changes in how much they eat and move to prevent weight gain.

Cheryl D. Toner, MS, RDN, is president of CDT Consulting, LLC. Ms Toner has a private nutrition counseling practice and also specializes in food, nutrition, and health communications and strategy.

Marianne Smith Edge, MS, RD, LD, FADA, is senior vice president of nutrition and food safety at the International Food Information Council Foundation in Washington, DC, where she directs the nutrition and food safety strategic initiatives and consumer research.

The International Food Information Council Foundation is a nonprofit organization dedicated to the mission of effectively communicating science-based information on health, nutrition, and food safety for the public good. The foundation is primarily funded by the broad-based food, beverage, and agricultural industries.

The authors have no conflicts of interest to disclose.

Correspondence: Marianne Smith Edge, MS, RD, LD, FADA, International Food Information Council (IFIC) and IFIC Foundation, 1100 Connecticut Ave NW, Suite 430, Washington, DC 20036 (

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins