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.