Let’s be clear
Rising prices are not the only challenge consumers face in today’s grocery aisle. It seems one needs to be a linguist, scientist, and mind reader to comprehend the myriad terms cluttering the labels on the most popular packaged foods.
The latest United States Food & Drug Association (FDA) food label is confusing at best, particularly for shoppers seeking “healthier” options. A recent consumer survey revealed that the perception of healthfulness is a key driver of food purchases for most individuals. But gauging the health quality of foods can be daunting — made all the more difficult by misleading nutrition information that appears on most food labels.The growing recognition that poor food choices are linked to a prevalence of obesity and chronic disease globally has inspired public health leaders to market the benefits of healthful eating. Step one: More readable and revealing food labels.
The FDA was officially established in 1906 with the signing of the Food and Drugs Act by President Theodore Roosevelt. This act marked the beginning of federal regulation of food and drugs in the U.S., aiming to ensure the safety, effectiveness, and labeling of consumer products.
Food labeling regulations in the U.S. evolve with the times to address concerns related to food safety, nutrition, consumer information, and public health. The aim has been to ensure that consumers have access to accurate and comprehensive information about the foods they purchase and consume.
The table below presents a brief overview of the history of U.S. food labels.
Food Grouping |
NutriScore |
1906 Pure Food and Drug Act |
Prohibited sale of misbranded or adulterated foods/drugs in interstate commerce; laid the foundation for future regulations by establishing the U.S. Food and Drug Administration (FDA). |
1938 Food, Drug, and Cosmetic Act |
Expanded FDA’s authority, requiring that food labeling be truthful and not misleading; introduced the concept of “adequate directions for use” on labels. |
1990 Nutritional Labeling and Education Act (NLEA) |
Mandated that food products carry standardized nutrition labels that include information such as serving sizes, calories, nutrients, and ingredients. |
1994 Dietary Supplement Health and Education Act (DSHEA) |
Established specific labeling requirements for dietary supplements, including providing an ingredients list. |
2004 Food Allergen Labeling and Consumer Protection Act (FALCPA) |
Required food labels to clearly identify common food allergens like peanuts, tree nuts, milk, eggs, fish, shellfish, wheat, and soybeans. |
2023 Modernization of Food Labeling (FLMA) |
Establishing standard front-of-package (FOP) nutrition labeling for all packaged foods; FOP highlights nutrients that are overconsumed and linked to chronic diseases |
Modern times
In 2023, the Food Labeling Modernization Act (FLMA) directed the FDA to establish a standard front-of-package nutrition (FOP) label that includes symbols and a rating system for all packaged food it regulates. This system would highlight nutrients that are overconsumed and linked to chronic diseases, much like other countries have done (see below). Use of FOP systems and symbols are not without controversy, however. With enormous profit in highly processed, nutrient-poor foods, it seems logical that food industry advocacy groups — the American Beverage Association and Sugar Association, among others — would favor labels that make it harder for consumers to determine the healthiness of a product. Many of these same food companies have been fighting consumer-friendly FOP labels for nearly two decades.
Below are some examples of terms used in deceptive labeling to make junk foods appear healthy. This is why it is so important to define and standardize terms and approaches to FOP labeling that are consistent, trusted, and easily understood.
What Label Says |
What Label Implies |
What is Truth |
What To Do |
“Made with whole grains”, or “made with real fruit” | 100% of grains used are whole. | Often includes only a “pinch” of whole grains, added to refined grains. | Choose only products labeled “100% whole grains” or “made with real fruit.” |
“Contains no cholesterol” | More desirable because it is a special formulation without cholesterol. | The food never contained cholesterol in the first place. Cholesterol is only found in animal products and some tropical fruit. | Don’t pay extra for plant products with this label. |
“Natural” | No man-made ingredients, organic, non-GMO. | Natural is not a nutrition claim; it’s a marketing claim. | Don’t be fooled; completely ignore claim. |
Sugary junk food that does not list sugar as the first ingredient | Sugar content is not high. | Food contains many forms of sugar, none of which are high enough to require it to list first. Cumulatively, combining many forms of sugar still adds up. | Don’t fall for this sugar shell game. Sugar aliases include corn syrup solids, crystal dextrose, evaporated cane juice, fructose sweetener, fruit juice concentrates, malt syrup, maple syrup, molasses, concentrated fruit juice, hexitol, inversol, isomalt, maltodextrin, malted barley, nectars, pentose, raisin syrup, and others. |
More than just a label
The goal of any FOP nutrition label is to increase the proportion of consumers who can easily notice, comprehend, and use available food-label information to make more nutritious choices. The whole point is to prevent or reduce obesity and other diet-related chronic diseases and promote a healthy lifestyle.
Deciding what information should be presented on the FOP label is a conundrum. Food manufacturers, science experts, consumer advocates, and public health officials all compete to prioritize their respective agendas and insights. Since there is so much possible information to display, reaching a consensus on a FOP system that most stakeholders would adopt has proven difficult. Rarely is everyone satisfied.
More than 40 countries have employed easy-to-understand, FOP nutrition information that reveals at a glance which foods are more — or less — healthful.
For example, the U.K.’s FOP label sets forth a recommended format using red, amber, and green color-coding, and percentage-reference intakes (RIs). This FOP label is also known as “traffic light” labeling in which green indicates the specific nutrient content is “low” and is a “healthy” choice; amber means the product is neither high nor low in the specific nutrient – in other words, you can eat these foods most of the time; and red warns the food is high in fat, saturated fat, salt, or sugar, and consumers should limit their intake.
Canadian FOP-labeling
Research shows that frequently eating foods high in sodium, sugar, or saturated fat can lead to increased health risks, including stroke, obesity, heart disease, type 2 diabetes, high blood pressure, and some types of cancers. Based on that information, the Canadian government mandated FOP nutrition symbol(s) be applied to prepackaged foods that meet or exceed set levels for these nutrients.
Some foods that are not required to display a FOP symbol (in Canada and potentially in the U.S.), include individually packaged portions intended to be served in restaurants. These might be cracker packets served with soup or single-serve creamers with coffee; milk and cream sold in refillable glass containers; foods in very small packages; raw, single-ingredient whole cuts of meat, poultry, and fish; and finally, foods with a protective effect on health, such as fruits and vegetables without added sodium, sugars, or saturated fat.
The Canadian FOP nutrition symbol features a magnifying glass inside a box that highlights whether a food is high in sodium, sugars, saturated fat, or any combination of these (see figure). The graphic is black and white. The heading “High in” appears in bold black letters inside the box at the top; there is at least one bar inside the box that identifies the product as “high in sat fat,” “high in sugars,” and/or “high in sodium,” as applicable.
FOP labeling is based on the Canadian Food Inspection Agency’s model for nutrient profiling. Different countries rely on the model to help consumers quickly recognize and compare different products. The FOP highlights (total) sugars, saturated fats (“saturates”), salt, and calories in 100g or 100ml of a food.
Anticipated American FOP label
Thus far, the U.S. does not require FOP labeling, relying instead on the food industry’s voluntary efforts, laden with confusing numbers and percentages. Thus far, we know that the U.S.-FOP label will complement a newly condensed Nutrition Facts label, by displaying simplified, at-a-glance nutrition information to help consumers quickly and easily make more healthy food selections.
As of April 2024, based on all of the available data, the following information will most likely appear on the soon-to-be-released U.S.-FOP label.
- Calorie content either as per serving, or per package, regardless of size.
- Descriptive information about serving size in order to reinforce and highlight the actual quantity of food associated with the calorie content.
- Number of servings for packages that contain three or more servings.
- Indicate whether a product is high or low for the following nutrients: saturated fat, sodium, added sugars, fiber content, and calcium. It most likely will be similar to the U.K. traffic light symbol.
- In response to concerns about the high prevalence of overweight and obese children and teens, the FDA is considering nutrition standards for the FOP label to indicate which products might appropriately be marketed to children.
A “high in” label (similar to Canada’s) has been proposed by the FDA and is superior to the food-industry-backed “per serving” label. It avoids numbers and percentages and helps the consumer focus on key information. As for label colors, the agency has suggested using them, by assigning colors to individual nutrients.
Critics have argued that the proposed label would be confusing since it would be like pulling up to a traffic light that is red, yellow, and green all at the same time. How could a driver possibly know what to do?
Stayed tuned!
References
- 80 Years of the Federal Food, Drug, and Cosmetic Act. Acton, R. B., et al. “Comparing the effects of four front-of-package nutrition labels on consumer purchases of five common beverages and snack foods: Results from a randomized trial.” 2022. Journal of the Academy of Nutrition and Dietetics. 122(1), 38.British Nutrition Foundation. “Bridging gaps in food labeling.” 2022. Nutrition Bulletin. 47:2.FDA’s Nutrition Initiatives
- Front of Package Labeling Literature Review. 2023. U.S. Food & Drug Administration.
- Front-of-pack Nutri-Score labeling in France: An evidence-based policy.
- Front-of-Package (FOP) Food Labeling: Empowering consumers and promoting healthy diets.
- Julia, C., et al. “Are foods ‘healthy’ or ‘healthier’? Front-of-pack labeling and the concept of healthiness applied to foods.” 2022. British Journal of Nutrition. 127(6):948.
- Katz, D.L., et al. “The stratification of foods on the basis of overall nutritional quality: The Overall Nutritional Quality Index.” 2009. American Journal of Health Promotion. 24(2):133.
- Scientific opinion on the scientific advice related to nutrient profiling for the development of harmonised mandatory front-of-pack nutrition labeling and the setting of nutrient profiles for restricting nutrition and health claims on foods. Swedish Food Agency.
- Wartella, E.A., et al. “Front-of-package nutrition rating systems and symbols: Phase 1 Report. Institute of Medicine of the National Academies. The National Academies Press. 2010. Free download.