FDA’s proposed changes to the Nutrition Facts label are good, but could be better

Every day, millions of Americans use the Nutrition Facts labels on food packages to make healthy choices. The U.S. Food and Drug Administration has recently proposed changes to make the labels even more useful.

It’s an important move that could help curb the skyrocketing number of Americans with type 2 diabetes, osteoarthritis, and other weight-related conditions. “The current labels have had the effect of reducing the total fat intake in the American diet,” says Dr. Clifford Lo, an associate professor of nutrition at the Harvard School of Public Health. When food makers take out fat — often healthy unsaturated fat — to improve the “total fat” number on the label, they tend to add in sugar and other rapidly digested carbohydrates. “Unfortunately, this has often led to an increase in calories and sugar in the diet, now linked to increasing obesity and diabetes,” says Dr. Lo

The proposed label will look a bit different than what we’re used to. It will:

• list information about added sugars — sweeteners that are added to foods during processing — so you’ll know how much extra sugar is in the product.
• update daily values for sodium and dietary fiber, and declare the amount of potassium and vitamin D. Both are what the FDA calls “nutrients of public health significance” that most people don’t get enough of.
• remove the “Calories from Fat” category while continuing to list types of fat. This is important because we now know that the types of fat (saturated, unsaturated, and trans) in a person’s diet are more important for health than the amount of fat.

For foods that come in larger packages but could be consumed in one sitting, manufacturers would have to use a two-column label showing calorie and nutrition information for both a single serving and the entire package. Examples of this might be a 24-ounce bottle of soda or a pint of ice cream. That way, people would be able to easily understand how many calories and nutrients they are getting if they eat or drink the entire package at one time.

The new label must also show portion sizes that realistically reflect how much people eat, not how much they should eat.

Going farther

Will these changes help you make the best choices in the supermarket?

“They are a step in the right direction, but they don’t go far enough with sugar, ingredient listing, and nutrient claims,” says Kathy McManus, director of the Department of Nutrition at Harvard-affiliated Brigham and Women’s Hospital.

Her opinion echoes those in two perspective pieces in tomorrow’s New England Journal of Medicine.

One is from former FDA chief Dr. David Kessler (a Harvard Medical School grad), who oversaw the creation of the original Nutrition Facts label. He wants the FDA to include a Daily Value for added sugar. He also wants added sugars to be lumped together on a package’s ingredient list. Right now, each added sugar is listed separately, “pushing ingredients such as fructose, corn syrup, dextrose, sucralose, brown rice syrup, and maltodextrin to lower positions on the [food ingredients] list,” he writes. “If we instead defined all forms of sugar as a single ingredient, sugar might emerge near the top in many products’ lists.”

Kessler also wants the new labels to list a product’s top three ingredients on the front of a package. That way, if you saw one package with a top-three ingredients list of whole-grain wheat, raisins, and wheat bran, you’d know it was probably better for you than a product with a top-three ingredients list of sugar, corn flour, and wheat flour.

The other perspective comes from George Washington University researchers Allison C. Sylvetsky and William H. Dietz, who was also the director of the Division of Nutrition, Physical Activity, and Obesity at the CDC. They make the case that food labels should be more like the ones in Canada that say right on the front of a package if a food contains an artificial sweetener, and elsewhere list the amount of each type of sugar in each serving. The researchers say this information would help us make better food choices for ourselves and our children.

Using the Nutrition Facts label today

The FDA is still getting input on the new label, and hasn’t made final decisions yet on what it will look like. Even when a decision is made, food manufacturers will have two years to implement the changes. Here are some tips to help you before the new label debuts:

• When it comes to sugar, follow the American Heart Association guidelines of no more than 6 teaspoons (24 grams) of added sugar per day for women and 9 teaspoons (36 grams) for men. Limit or avoid foods with added sugars such as sucrose, high-fructose corn syrup, molasses, brown sugar, and honey.
• Keep track of how many servings you’re eating. The current Nutrition Facts label information is based on one serving, not one package.
• Look at the number of calories per serving and fit that into your daily calorie goal.
• For fat, aim for zero grams of trans fat and try to keep saturated fat low — fewer than 15 grams a day if you take in about 2,000 calories a day. Don’t work to limit unsaturated fats — they are good for health.
• Remember that percent daily values are based on a 2,000-calorie-a-day diet. Modify the percentage if you usually take in fewer or more calories than that.
• Choose foods that are higher in fiber.