Health & Fitness

Seeking the right recipe for food labels

You can give people all sorts of useful information, but that doesn't mean they'll use it.

Case in point: the Nutrition Facts panels inscribed on nearly every can, box, jug, carton and plastic wrapper in which food has been sold since 1994. These small, unassuming charts are there to enlighten consumers about the fat, sodium, carbohydrate, fiber, sugar, protein, vitamin, mineral and calorie content of the product inside.

Many consumers say they rely on this information — in a survey conducted last year by the International Food Information Council Foundation, 68% of Americans credited the labels with helping them decide which foods and beverages to buy (and which to pass up).

But research suggests that people may not use Nutrition Facts as much as they say they do. For instance, although 33% of people in one study said they almost always check calorie totals on the labels, an eye-tracking device revealed that only 9% really did so when they took a simulated shopping trip. In that same study, between 20% and 31% of people said they almost always look at figures for total fat, trans fat and sugar, but only 1% were observed actually reading that key data, according to the 2011 report in the Journal of the American Dietetic Assn.

This woeful situation has convinced nutritionists, food manufacturers and public health experts that the humble Nutrition Facts label could probably use a little help — some way to convey key information as quickly as possible.

"Consumers tend to spend only about one second looking at nutrition information when making their decision about whether or not to purchase a product," says Dan Graham, a researcher at the Obesity Prevention Center in the University of Minnesota's School of Public Health and coauthor of the eye-tracking study.

Fortuitously, the interested parties all seem to agree on the best thing to do: add a short, clear label conveying essential nutrition information to the front of packages.

But that's where the agreement ends. No consensus has developed on what the labels should say or how they should say it. Several fundamentally different approaches have come to the fore:

Every packaged product gets a label that simply summarizes key elements of the Nutrition Facts panel. Consumers can use it to draw their own conclusions about how healthful the product is.

Only products that meet a set of established nutrition criteria earn labels, which "endorse" the products as healthful.

Every packaged product gets a label, which either endorses the product, disses it or gives it a mixed nutritional review.

A variety of snazzy new front-of-package labels have cropped up around the country in recent years. Some have taken the first approach, others the second and none the third (so far).

But a version of the third approach was embraced by a committee of experts convened by the Institute of Medicine to advise the Food and Drug Administration on the best way to proceed with front-of-package nutrition labels.

After studying nutrition rating systems and the science behind them — as well as how consumers use and understand front-of-package labels — the committee issued a report last fall that made several recommendations to the FDA. A single, standardized labeling system should replace all other systems already in use, and it should be used on all food and beverage products, not just healthful ones, the committee advised. The system should also give clear guidance about the healthfulness of products instead of taking a neutral, just-the-facts approach, committee members decided.

FDA spokeswoman Siobhan DeLancey says the agency is reviewing the committee's report "with the ultimate goal of providing a front-of-pack labeling system that is simple, straightforward and consistent with the Nutrition Facts panel that is already required."

But there is no word yet as to how or when the FDA will act. In the meantime, parties in the food industry continue to step up to the plate with new labeling systems.

In its own research, the Grocery Manufacturers Assn. found that shoppers just want facts. "Once they had command of the facts, they felt better prepared to make decisions," says Sean McBride, vice president for communications and marketing for theWashington, D.C.-based group.

And so the GMA, in collaboration with the Food Marketing Institute of Arlington, Va., developed "Facts Up Front." In a series of boxes, consumers can quickly scan the amount of calories, saturated fat, sodium and sugar in a single serving, along with up to two additional nutrients (such as fiber, protein, calcium or vitamin C).

Wal-Mart's "Great for You" label takes the endorsement approach. The logo features a stick figure standing on a green field, arms raised triumphantly overhead. To qualify for this seal of approval, a food or drink must meet certain standards for sodium, added sugars and fat content. Sub-greatness in even a single category is enough to knock it out of the running.

Marion Nestle, a professor of nutrition, food studies and public health at New York University, says Wal-Mart's system is a "substantial improvement" over Facts Up Front, since it makes a value judgment using standards she considers "pretty strict."

However, that's not to say there's no room for improvement.

For one thing, Nestle — along with most other scientists — believes that in order to be most effective, nutrition labels should give both positive and negative product reviews. Of course, any such system would hold little appeal for the food industry. As Nestle observes, "No company is going to put a 'Don't buy me' sign on its products."

Consumers don't seem to relish negative assessments either. In the 2011 survey by the International Food Information Council, 63% of Americans said they'd rather hear about what they should eat instead of what they shouldn't.

Still, research shows that a system that flags both good and bad products can be very effective. One study tested a "traffic-light system," in which green, amber or red labels indicated low, so-so or high amounts of sodium, sugar and fat. Consumers who saw these labels were three to five times better at discriminating between healthful and unhealthful foods than consumers who tested labels that merely displayed nutrient stats as percentages of recommended daily intake. The study was presented at the European Congress on Obesity in 2009.

Another success for the traffic-light approach came in the cafeteria of Massachusetts General Hospital in Boston. During a three-month trial, sales of items marked red fell by 9.2%, while sales of items marked green rose 4.5%, according to a study published online in January in the American Journal of Public Health. Though the experiment ended in 2010, the cafeteria has continued to use the labels, says study leader Dr. Anne Thorndike.

While the Institute of Medicine committee didn't opt for a traffic-light system, they devised another way to give products a deserved thumbs down. Labels would always include the number of calories in a serving. They would also display up to three stars or checks (the FDA can decide which icon to use) indicating whether the item met standards for saturated and trans fats, sodium and added sugars. A quick scan of stars or checks would convey an overall sense of an item's nutritional value. If there weren't any stars or checks at all, shoppers could infer that the item was a bad bet nutrition-wise.

At the same time, the information on the label would be deliberately vague. To figure out which criteria a product met and where it fell short, consumers would have to refer to the Nutrition Facts label. One of the committee's goals is to get more people to use the comprehensive label more often, says chairwoman Ellen Wartella, a communications expert at Northwestern University in Evanston, Ill.

Many scientists see the committee's work as the best hope for establishing a universal front-of-package labeling system. After all, only the FDA can mandate their use.

In the meantime, any front-of-package label may be better than none, some experts say. Others are suspicious of industry efforts to fill the void, especially in light of the Smart Choices program of 2009.

With big-name supporters including General Mills and PepsiCo, Smart Choices awarded green checks to foods that met its criteria for fat, cholesterol, sugar and sodium. But the standards were so lax that cereals like Froot Loops and Cocoa Krispies earned checks. The program prompted so much criticism that it was shut down after just a few months.

health@latimes.com

Copyright © 2014, Los Angeles Times
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