We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |

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.
Text Size: A A A
Published online


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)


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.