The Food and Drug Administration unveiled its proposal for a new Nutrition Facts label on Feb. 27, the first revamp of the back-of-the-box listing since it was introduced 20 years ago. The agency said the label redesign—which features bolder calorie totals, a listing for added sugars and information on vitamin D and potassium—reflects current science on what nutrients Americans are potentially lacking in their diets and what things (sugar, calories) they are getting too much of. It also takes into account the amount we tend to eat, which is larger portion sizes than in the 1970s and 1980s. Thus a 20-ounce bottle of soda will no longer be considered two and a half servings, at least according to the label.
Could tweaking the black-and-white chart of nutrients really have an impact? The FDA seems to think so. According to surveys the agency has conducted, 58 percent of people report they "often" read a food label before they purchase a food.
The FDA will accept public comment on the new labels for 90 days and then issue a final decision. (You can leave feedback for the FDA here.) If the new rules are approved, food manufacturers will have two years to adopt the new label.
Alice H. Lichtenstein is the Gershoff Professor of Nutrition Science and Policy at the Friedman School and the director of the Cardiovascular Nutrition Laboratory at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts. She talked with Tufts Now about how the new label might help people make better choices at the grocery store, and how it might spur food manufacturers to make some changes, too.
Tufts Now: What do we know about how people use the Nutrition Facts label?
Alice H. Lichtenstein: We know a lot less about how people use labels than we do about the science behind diet and chronic disease risk. However, there are a few reports suggesting that people may not have been using some of the information on the label accurately or that there may, in some cases, be some misunderstanding about the label information.
Part of that has to do with calories and portion size. For packages that weren't resealable, some people didn't look that closely at the number of servings and just assumed that the calories listed represented the whole package. So for a number of foods, serving sizes have been modified to reflect what we actually consume and/or to reflect what is in the whole package. Things like ice cream, for example. A serving size for ice cream is currently one half cup, but people rarely eat just a half cup of ice cream—most of the time they eat a full cup. Bagels were labeled as half a bagel for one serving, and now they will be listed as a whole bagel per serving. The calories listed will reflect that.
Is there a danger that people will think that is how much they should be eating at one sitting? As in, "the serving size is bigger, so I guess we are allowed to eat more."
It's not clear that anyone uses the serving sizes to give them an idea of how much is an appropriate portion to consume. I think that is very likely more the exception than the rule. I suspect many times when people are pouring breakfast cereal into a bowl, the determinant is the size of the bowl, and the bowl holds more than a single serving as defined on the current labels. Certainly when you see people pouring a bowl of cereal on TV, it looks pretty big.
Why is listing added sugars important?
If the American population is going to be asked to adhere to the 2010 Dietary Guidelines, which recommend that added sugars be limited, we need to provide the information they need to do that. I think in this case, the FDA was very proactive. The definition of added sugars is quite extensive. It covers all the potential sugars that are used as added sugars, but sometimes masquerade as other things. So things like fruit juice concentrate and corn syrup are considered added sugar. It is particularly important for foods like yogurt. The majority of yogurt consumed is pre-sweetened, and it is difficult to tell how much added sugar is in there.
But if you assume that all sugar—added or naturally present—is metabolized the same way, why does breaking it down on the label matter?
Because some foods that have naturally occurring sugar also come with other nutrients, particularly essential nutrients. Something like milk naturally has the sugar lactose, but we depend on milk for providing calcium, high-quality protein and a number of other minerals plus vitamins A and D. Fruits such as peaches and nectarines are high in sugar, but they also carry many other nutrients and fiber, so we don't want to deter people from consuming them or other fruits. In general, we don't eat enough fruits and vegetables in the United States.
Neither the current label nor the proposed label lists a daily value for how much sugar we are supposed to eat. How will people know how many grams of sugar is reasonable?
We don't need added sugars. So if you put a daily value there, that implies that we need it and people should try to achieve it. And that is not consistent with what daily values are. You'll notice there is not one for trans fat either, because we don't need it.
So if a product has any added sugar, I should be cautious about it?
I'm not sure that's what the current thinking is. The thinking is if you've got two brands of strawberry yogurt, and one has 20 grams of added sugar and one has 40 grams, it is probably better to pick the one that has 20 grams. Of course, you also want to look at the saturated fat content, but assuming all other things are equal, you might want to choose the one that is lower in added sugar.
There are also going to be some changes to which nutrients are listed on the label. Products won't have to list how much vitamin A and C they have, but they will have to say how much vitamin D and potassium they have. Why?
There is a limited amount of information that people can process. It turns out we are doing fine with A and C in the United States, so why take up space with that information? And it's important for us to be mindful of calcium and iron, so they are going to stay on. But the nutrients where there may be some shortfall are vitamin D, which is needed for bone health, and potassium, which helps prevent high blood pressure. So we might as well include that information, which is going to be useful for individuals who want to make an effort to improve their diet.
Do you hope that the new label will encourage more food manufacturers to fortify their products with things such as vitamin D and potassium?
Not necessarily. One needs to be very concerned about encouraging supplementation across the board. That could lead to overconsumption, and for things like vitamin D and vitamin A, there are reasons for concern about overconsumption.
So we don't want manufacturers to start pumping nutrients into their foods willy-nilly. But do you expect manufacturers will make other changes?
That certainly is a collateral benefit of modifying labels, where companies reformulate to make the label look better, and the default option for the consumer is a better product regardless of whether they use the label. For example, manufacturers may decide to reformulate their yogurts to decrease the amount of added sugar. I'm a very, very strong proponent of that from a public health perspective.
That was very successful with trans fat. Once trans fat had to be put on the Nutrient Facts label, a number of companies reformulated to dramatically reduce the trans fat content of their foods. A high proportion of new foods that have been introduced after that change do not have trans fat.
In New York City, banning the use of partially hydrogenated fat, the major source of trans fat, essentially made the default option the healthier option. The people who benefit the most from that are actually the ones who have the lowest nutrition literacy and the lowest motivation for making change.
But people don't have to wait for the companies to make changes. Remember, the new label will not become mandatory until two years after the FDA issues the final ruling. In the meantime, shoppers can use the current label information to their best advantage by looking at the calories per serving and the serving size, and if they are consuming a larger serving size than listed, doing the math.