Counting Calories—Caveat Emptor

David B. Allison, PhD; Stanley Heshka, PhD; Dennis Sepulveda; Steven B. Heymsfield, MD
JAMA. 1993;270(12):1454-1456. doi:10.1001/jama.1993.03510120076034.
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Objective.  —To determine the accuracy of caloric labeling of "diet" and "health" foods and whether the accuracy differs for certain categories of food suppliers.

Design.  —Survey; "diet" and "health" foods were analyzed via bomb calorimetry and categorized as regionally distributed, nationally advertised, or locally prepared.

Setting.  —Foods were sampled from retail merchants throughout the borough of Manhattan, New York, NY.

Sample.  —A convenience sample of 40 food items including regionally distributed (n=12), nationally advertised (n=20), and locally prepared items (n=8).

Main Outcome Measures.  —Number of kilocalories per item and number of kilocalories per gram.

Results.  —All locally prepared foods had more actual than labeled kilocalories. The mean percentage of actual kilocalories greater than the labeled kilocalories (mean percentage over label) per item was 85.42% (SD=77.88%; P=.01). Regionally distributed foods had significantly more kilocalories than were reported (P=.001 for kilocalories per item, P=.02 for kilocalories per gram) and mean percentage over label per item was 25.22% (SD=15.58%) and per gram was 14.97% (SD=17.95%). Nationally advertised foods did not have significantly more actual than reported kilocalories (P=.37 for per item, P=.78 for per gram). Mean percentage over label per gram was —0.01% (SD=9.13%) and per item was 2.18% (SD=13.93%).

Conclusion.  —These findings suggest that food labels may be inadequate sources for caloric monitoring. Health care professionals should consider the accuracy of caloric labeling when advising patients to use food labels to help monitor their caloric intake.(JAMA. 1993;270:1454-1456)


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