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Am J Public Health. 2001 March; 91(3): 418–424.
PMCID: PMC1446579

A comparison of knowledge and attitudes about diet and health among 35- to 75-year-old adults in the United States and Geneva, Switzerland.


OBJECTIVES: This study compared responses of US and Geneva residents to items on analogous questionnaires concerning knowledge and attitudes about diet and health. METHODS: Comparable data were available from 2 population-based sample surveys: the Cancer Control Supplement of the 1987 National Health Interview Survey and the 1994 Bus Santé 2000 in Geneva, Switzerland. Samples included 10,366 US respondents and 698 Geneva respondents, aged 35 to 74 years. The analysis involved descriptive statistics, contingency tables, and linear regression models. RESULTS: In both the United States and Geneva, health consciousness was greater among women and more highly educated persons than among other groups. Compared with Americans, Genevans assigned more importance to avoiding salt, sugar, and overweight (odds ratio = 1.6, 2.9, and 5.9, respectively) and less importance to lowering cholesterol (odds ratio = 0.6). Genevans were more likely to recognize the relatively high fiber content of lettuce, carrots, and apples. Recognition of low-fat foods was slightly better in the United States. CONCLUSIONS: Knowledge and attitudes differed despite high general diet and health awareness in both populations. Identifying why generally similar dietary guidance messages are embraced to different extents across cultures may facilitate global implementation.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Butrum RR, Clifford CK, Lanza E. NCI dietary guidelines: rationale. Am J Clin Nutr. 1988 Sep;48(3 Suppl):888–895. [PubMed]
  • James WP, Ralph A, Bellizzi M. Nutrition policies in western Europe: national policies in Belgium, The Netherlands, France, Ireland, and the United Kingdom. Nutr Rev. 1997 Nov;55(11 Pt 2):S4–20. [PubMed]
  • van Mechelen W. National policies for promoting physical activity, physical fitness and better nutrition in Europe. World Rev Nutr Diet. 1997;81:136–147. [PubMed]
  • Truswell AS. National policies promoting better nutrition, physical fitness and sports for all in Australia. World Rev Nutr Diet. 1997;81:148–159. [PubMed]
  • Lüthy J. The development of a nutrition policy in Switzerland. Nutr Rev. 1997 Nov;55(11 Pt 2):S29–S31. [PubMed]
  • Heimendinger J, Van Duyn MA, Chapelsky D, Foerster S, Stables G. The national 5 A Day for Better Health Program: a large-scale nutrition intervention. J Public Health Manag Pract. 1996 Spring;2(2):27–35. [PubMed]
  • Carleton RA, Dwyer J, Finberg L, Flora J, Goodman DS, Grundy SM, Havas S, Hunter GT, Kritchevsky D, Lauer RM, et al. Report of the Expert Panel on Population Strategies for Blood Cholesterol Reduction. A statement from the National Cholesterol Education Program, National Heart, Lung, and Blood Institute, National Institutes of Health. Circulation. 1991 Jun;83(6):2154–2232. [PubMed]
  • Cotugna N, Subar AF, Heimendinger J, Kahle L. Nutrition and cancer prevention knowledge, beliefs, attitudes, and practices: the 1987 National Health Interview Survey. J Am Diet Assoc. 1992 Aug;92(8):963–968. [PubMed]
  • Glanz K, Brug J, van Assema P. Are awareness of dietary fat intake and actual fat consumption associated?--a Dutch-American comparison. Eur J Clin Nutr. 1997 Aug;51(8):542–547. [PubMed]
  • Popkin BM, Siega-Riz AM, Haines PS. A comparison of dietary trends among racial and socioeconomic groups in the United States. N Engl J Med. 1996 Sep 5;335(10):716–720. [PubMed]
  • Johansson L, Andersen LF. Who eats 5 a day?: intake of fruits and vegetables among Norwegians in relation to gender and lifestyle. J Am Diet Assoc. 1998 Jun;98(6):689–691. [PubMed]
  • de Graaf C, Van der Gaag M, Kafatos A, Lennernas M, Kearney JM. Stages of dietary change among nationally-representative samples of adults in the European Union. Eur J Clin Nutr. 1997 Jun;51 (Suppl 2):S47–S56. [PubMed]
  • Kearney M, Gibney MJ, Martinez JA, de Almeida MD, Friebe D, Zunft HJ, Widhalm K, Kearney JM. Perceived need to alter eating habits among representative samples of adults from all member states of the European Union. Eur J Clin Nutr. 1997 Jun;51 (Suppl 2):S30–S35. [PubMed]
  • Buttriss JL. Food and nutrition: attitudes, beliefs, and knowledge in the United Kingdom. Am J Clin Nutr. 1997 Jun;65(6 Suppl):1985S–1995S. [PubMed]
  • Glanz K, Basil M, Maibach E, Goldberg J, Snyder D. Why Americans eat what they do: taste, nutrition, cost, convenience, and weight control concerns as influences on food consumption. J Am Diet Assoc. 1998 Oct;98(10):1118–1126. [PubMed]
  • Lennernäs M, Fjellström C, Becker W, Giachetti I, Schmitt A, Remaut de Winter A, Kearney M. Influences on food choice perceived to be important by nationally-representative samples of adults in the European Union. Eur J Clin Nutr. 1997 Jun;51 (Suppl 2):S8–15. [PubMed]
  • Gibney MJ, Kearney M, Kearney JM. IEFS pan-EU survey of consumer attitudes to food, nutrition and health. Eur J Clin Nutr. 1997 Jun;51 (Suppl 2):S2–S58. [PubMed]
  • Devine CM, Sandström B. Relationship of social roles and nutrition beliefs to fat avoidance practices: investigation of a US model among Danish women. J Am Diet Assoc. 1996 Jun;96(6):580–584. [PubMed]
  • Zunft HJ, Friebe D, Seppelt B, de Graaf C, Margetts B, Schmitt A, Gibney MJ. Perceived benefits of healthy eating among a nationally-representative sample of adults in the European Union. Eur J Clin Nutr. 1997 Jun;51 (Suppl 2):S41–S46. [PubMed]
  • Cockerham WC, Kunz G, Lueschen G. On concern with appearance, health beliefs, and eating habits: a reappraisal comparing Americans and West Germans. J Health Soc Behav. 1988 Sep;29(3):265–269. [PubMed]
  • Morabia A, Bernstein M, Héritier S, Ylli A. Community-based surveillance of cardiovascular risk factors in Geneva: methods, resulting distributions, and comparisons with other populations. Prev Med. 1997 May-Jun;26(3):311–319. [PubMed]
  • Kuczmarski RJ, Flegal KM, Campbell SM, Johnson CL. Increasing prevalence of overweight among US adults. The National Health and Nutrition Examination Surveys, 1960 to 1991. JAMA. 1994 Jul 20;272(3):205–211. [PubMed]

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