Labels will change, but will diet?

Getting Americans to choose healthier foods will take more than adding a line about trans fat to nutrition labels.

A week after the U.S. Food and Drug Administration announced that packaged foods will have to list their trans-fat contents by January 2006, some consumers, interviewed in local supermarkets, said they’d never heard of trans fat. Inglewood resident Emmanuel Juarez said the term didn’t even sound familiar. “I don’t know anything about it,” he said.

Consumers must learn not only to look for the new information, but to understand what it means for their health and how to choose healthier foods. But it’s the manufacturers that could have the biggest impact on the choices we make.

The FDA estimates that the new line on packaged foods’ nutrition facts panels will prevent 600 to 1,200 heart attacks a year, saving 250 to 500 lives annually by 2009.

That calculation is based, an FDA official said, not just on the number of people who use food labels, but on the rate at which the labeling change will spur manufacturers to reduce or remove trans fat from products currently on the market.

“Most people do not even pick up the package and look at the label” on packaged foods, said Gail Frank, professor of nutrition at Cal State Long Beach and spokesperson for the American Dietetic Assn. “Why do we think having a trans-fat listing is enough to make people drop a food item or put it back on the shelf?”

Studies have shown that people who do read food labels regularly tend to have low-fat diets. They also tend to be women, people under 35 years of age, and those with more than a high school education, according to a study conducted at the Fred Hutchinson Cancer Research Center in Seattle in 1999. In other words, many people who read the food labels are those least likely to need big dietary changes.

In recent years more than half a dozen studies have confirmed that trans fat, a type of unsaturated fat that acts like saturated fat, increases levels of artery-clogging LDL cholesterol in the blood. The fat, also known as partially hydrogenated oil, is produced when manufacturers add hydrogen to vegetable oils to make them solid and more durable. It’s found in many cookies, crackers, snack foods and fried foods. It’s also found naturally in red meats and dairy products containing fat.

The FDA is working with the National Heart, Lung, and Blood Institute at the National Institutes of Health to develop educational materials about the fat and is considering additional trans-fat labeling, including a footnote on the nutrition facts panel to remind consumers that trans- and saturated-fat levels should be kept low for a “heart-healthy diet.”

The agency also may soon grant permission for manufacturers to advertise foods as “trans-fat free.” Such health claims made on the covers of food packaging tend to have more influence on the decisions people make about what foods to eat than do nutrition facts labels, said Matthew Kreuter, director of the health communication research laboratory at the Saint Louis University School of Public Health.

Margo Wootan, director of nutrition policy at the Center for Science in the Public Interest, the advocacy group that led the effort to get trans fat listed on food labels, said labels are an important step in large part because they force food makers to change. “Once food companies have to reveal trans fat, they’re likely to reformulate foods to reduce the fat,” she said.

Such changes are underway. Last year, Frito Lay reformulated several snack foods to remove trans fat in anticipation of the FDA’s announcement. Several margarine manufacturers have taken similar steps, added Wootan. And health-food retailer Whole Foods announced last month that its stores no longer would carry any products containing trans fat.

But simply calling attention to trans fat may not be enough. Wootan said the new label won’t put trans fat amounts into the context of a daily diet. That is, the new labels will list only the grams of trans fat per serving, not the daily amount recommended for a healthful diet.

“The number on the label can sound low but really be a lot,” said Wootan. People consume an average of just under six grams of trans fat daily, but according to a report by the National Academy of Sciences, on which the FDA’s rule was based in part, the fat is not an essential part of a healthful diet.

The report didn’t recommend eliminating trans fat entirely, however. Because it’s in so many foods, avoiding it completely may make it hard to get an adequately nutritious diet, it said. The FDA has said more research is needed to establish a recommended daily value for the fat.

Even without a daily value, said Wootan, consumers can compare the number of grams of trans and saturated fats in different foods to “pick the one that’s best for the heart.” Right now, she said, “you only get half the story” from labels -- the amount of saturated fat alone. Wootan said her group recommends getting no more than 20 grams a day from trans and saturated fats combined. The American Heart Assn. says no more than 10% of daily calories should come from the two fats.

Frank and other nutritionists stressed that consumers still need to know how to interpret information on food labels. She cautioned that the labeling rule could encourage manufacturers to keep trans-fat levels below the reportable amount: half a gram per serving. The omission, she said, could mislead consumers.

“Some people eat a whole box of cookies in one sitting,” said Frank. “If the serving size has less than half a gram of trans fat, then the label won’t alert them.” That is, someone could plow through a whole box of cookies consuming 0.4 grams of trans fat per serving completely unaware of the total. If the box contains 10 servings, they’ve eaten four grams. People can avoid this, she said, by looking for the words “partially hydrogenated vegetable oil” in the ingredients -- a sure sign a food contains some trans fat.

“It’s a constant challenge to know how we can prevent heart disease and other chronic health problems,” said Frank. Food labels are one small part of a much larger effort, she said, but “they are an important piece of the puzzle.”