Consumers, manufacturers grapple with food packaging claims
Like most parents, Denise Devine, 49, a busy mother of two teenagers, cares about the food she feeds her family. Her main concern is to avoid foods, particularly cereals, that contain a lot of sugar. “I try to buy cereal that has fruit in it or isn’t too sugary,” she said. “Serving cereal has been a way I could get my daughter to drink milk, especially when she was younger. But too much sugar can make her agitated so I try to be careful.”
Even though Devine is motivated to buy healthy cereal, she always doesn’t read the Nutrition Facts Panel or the list of ingredients because she just sees a string of long words that don’t mean anything. Instead, she makes buying decisions using the information on the front of the package or a recommendation from a friend. As Devine said, “Sometimes you just don’t want to see the list. You think, ‘What is that’?”
Health claims up front
Research suggests that Devine is not alone in how she reacts to front-of-package labels. Short health claims on packaged foods tend to lead time-pressed shoppers to disregard the longer and more complete information on the back. The average consumer may believe the front-of-package claims are sanctioned by the government and are somehow “true.” While health claims on food packages are officially regulated by the FDA, they are not consistently enforced. Messages on the fronts of packages tend to be eye-catching and positive, while those on the back look less inviting and may include some negatives about the food.
The question is what can be done to help consumers make better food choices. Writing in the February 24, 2010, issue of the Journal of the American Medical Association, Marion Nestle, professor of nutrition at New York University, and David Ludwig, a professor of pediatrics at Children’s Hospital Boston summarized the problem: “Front-of-package labels may so thoroughly mislead the public that another option deserves consideration—eliminate all nutrition and health claims from the front of processed food packages while strengthening the Nutrition Facts Panel.”
Keep it simple
In early May 2012, the FDA released its Foods and Veterinary Medicines Strategic Plan for 2012-2016. Included in this plan is a goal to “provide accurate and useful information so consumers can choose a healthier diet and reduce the risk of chronic disease and obesity.” Part of this goal is to update the nutrition facts label so that serving sizes, daily values and important nutrients are easier to grasp. In addition, one key initiative of this plan is to “explore front-of-pack nutrition labeling opportunities.” These goals and initiatives have been met with guarded enthusiasm by some nutrition experts. As Nestle wrote on her Food Politics blog, “The FDA has already sponsored two Institute of Medicine reports on front-of-pack labeling. Does this mean the agency is ignoring them and intends further research?”
On October 20, 2011, a committee of the Institute of Medicine (IOM) issued a set of recommendations to create a single, standardized front-of-package labeling system that will make “healthier options unmistakable.” The key feature of this proposed system is a system similar to the Energy Star ratings, using a standard symbol placed in a consistent location on all products to represent calories “in common household measure serving sizes.” Also displayed on this symbol is a simple point system to rank foods, requiring no calculations or nutritional knowledge, based on amounts of three nutrients per serving: saturated and trans fats, sodium and added sugars. In addition, the recommendations include incorporating this system across all food products to allow comparisons across products.
The labeling jungle
All of this is a far cry from the current labeling landscape. Allowable health claims for immune system support, cardiovascular health and cancer prevention commonly appear on the fronts of food packages, the first point of engagement for consumers. Also on October 20, 2011, two food industry trade groups, the Grocery Manufacturers Association and the Food Marketing Institute, issued a joint statement launching Facts Up Front, a voluntary nutrition labeling system “to help busy consumers—especially parents—make informed decisions when they shop.”
The statement goes on to say that Facts Up Front was created in response to consumer preference “to make their own judgments, rather than have government tell them what they should and should not eat. This is the guiding principle of Facts Up Front, and why we have concerns about the untested, interpretive approach suggested by the IOM committee.” Facts Up Front displays nutritional information on four required elements per serving: calories, saturated fat, sodium and sugars. Individual products may include additional nutrients. Outside the food industry this system has been criticized as a cynical end run around the IOM recommendations.
What consumers can do
How can consumers make better food choices with the currently available labels? In a telephone interview, Alice Lichtenstein, a professor of nutrition at Tufts University and vice-chair of the IOM committee on Examination of Front-of-Package Nutrition Rating Systems, said that “consumers should focus on the Nutrition Facts Panel and what’s most important to them from a health perspective, for example, calories, sugars or sodium,” and pay special attention to ingredients and nutrients that are most relevant. She added that “it’s difficult to automatically or easily compare across cereals because they have different serving sizes. Lichtenstein herself does not buy many packaged foods, but when she does, she looks at the calories per serving and the position of whole grains in the list of ingredients.
Larry Cornick, marketing manager at New England Natural Bakers, a small organic food company in Western Massachusetts, agreed that “serving sizes drive the information on the nutrition facts panel,” adding that some manufacturers practice labeling deception, using serving sizes that might be better characterized as “snack” sizes in order to keep the calories per serving down. Cornick takes pride in his company’s conscientious approach to marketing, saying that the front-of-package health claim that the company’s Organic Antioxidant Superfruit Granola “supports the immune system” wouldn’t be there if it weren’t true.
Regulation past and present
Regulation of health claims on food packages in the U.S. has its roots in legislation from a century ago, beginning with the Pure Food and Drug Act of 1906, which prohibited statements that were “false or misleading in any particular.” For many years this wording was interpreted to mean that no health claims were allowed. By the 1960s, packaged foods had become much more common, and accurate labels more necessary. In the mid 1980s, Kellogg challenged this restriction by adding a health claim to its All-Bran cereal. This action was challenged by the FDA, but Kellogg fought, and won, the challenge, ushering in the era of allowable health claims on foods, as long as they were based on scientific evidence. The 1994 Dietary Supplement Health and Education Actfollowed, allowing, after food companies demanded it, foods to make the same labeling claims as dietary supplements could.
Kellogg has continued to push the health claim envelope, and was reprimanded by the FDA twice in recent years for claims on Frosted Mini-Wheats (attention improvement in children) and Rice Krispies (immunity in children). Today, three types of claims are allowed on food packages: health, nutrient content, and structure/function. As Cornick noted, “The big companies push the legislation.”
Health claims are not universally allowed on packaged foods. In the European Union, for example, health claims are not allowed on the labels until after they’ve been reviewed the European Food Safety Authority. Asked why this approach to labeling isn’t used in the U.S., Yoni Freedhof, a family physician and founder of Ottawa’s Bariatric Medical Institute, said by email that “there needs to be political will to make regulatory changes to labeling, and if politicians care more about ensuring the food industry’s interests are met than they do about the health of their constituents, then we certainly won’t see any changes.”
When Freedhof buys packaged foods he reads the fine print on the back, but pays little attention to front-of-package claims. “I use the nutrition facts panels to quickly scan for calories and sodium per serving, and front-of-package messaging to assume the food contained inside is one I ought to avoid, because if something needs to convince me it’s a healthy choice, it’s probably not. I’m not sure if any claim is more or less dangerous than any other, as all claims tend to influence the increased consumption of processed foods—something I think we should as a society be doing less of.”
In the end, are the health claims true? The answer might be a resounding, “sort of.” They generally seem to adhere to the letter, not the spirit, of the law, and are, after all, allowed by the country’s federal food and drug safety agency. One axiom common among nutrition experts is, “the front of the package is marketing, the back is truth.”
Meanwhile, Devine said she intends to try reading more of the Nutrition Facts Panel and ingredients lists, but really hopes something can be done to make it easier to understand the nutritional information and health effects. Her daughter is going off to college in the fall, and will be buying her own cereal—and probably ignoring the labels.Photos: IOM recommendations; Facts Up Front Icon All others by Susan Karcz