From my recent readings:
NFP - The Nutrient Facts panel was mandated by the Nutrition Labeling and Education Act of 1990 and has been on the back of most of our packaged food products since the early 1990s. It has become the area of contention for some consumer groups and health organizations. Also, the work that went into creating this label is similar to that which is occurring for the new front of pack objective.
RACC - this refers to the reference amount customarily consumed. RACCs formed the basis for the serving sizes on our NFP but they were created based on food intake surveys that were conducted in the late 1970s and 1980s. In other words, they are woefully out of date - still, the amount customarily consumed far exceeds the amount that should be consumed so updating the RACCs is also an area of controversy.
FDA - OWG - In 2004 the Obesity Working Group which was established by the FDA recommended that calories be highlighted and emphasized on all food packages and that calories per serving size be changed to calories per total package, or what a consumer might reasonably consume in one sitting - as food manufacturers may be deceptive in labeling practices otherwise. The title of the working group report was Calories Count.
CSPI - the Center for Science in the Public Interest has petitioned the FDA regarding deceptive and misleading labeling practices as well as front of pack claims that are in opposition of NLEA law. They also have ideas for a better NFP. CSPI has supported menu labeling, front of package labeling standardization, limits on sugar and the calories per package recommendation. I think they may be the organization I wish to work for in the future!
FOP (20) - Front of Pack labeling has been in practice since the 1980s when manufacturers began making claims or disclosing nutrient info on the front of a box to get consumers attention. At least 20 such symbols and systems were identified in the IOM Phase I report and in an article by Schor, et al in 2010. I have mentioned seeing some lately, but now realize that they have been proliferating for years. At this time, FOP systems are not standardized by criteria or source (i.e. health organization, food industry, governments, and private companies) and can be misleading and manipulative. This is in large part the impetus for the FDA announcement of proposed FOP regulation, letters to cease and desist to some companies, (i.e. giving healthy labels to super sweetened sugary cereals), an open docket for comments and information and the appointment IOM committee.
AHA - the American Heart Association was one of the first to offer a front of pack symbol. They have been working with the FDA to establish criteria for a heart healthy icon. They are also one of the health organizations that are concerned with sugar.
SUGAR - did you know that there is not a percent daily value for sugar intake in the US in regards to our labeling, and yet the Dietary Guidelines for Americans, the AHA, the CSPI, the Harvard School of Public Health, the World Health Organization and the Food Standards Agency of the UK have all named an upper limit?
2000-2500 calorie diet - this is a REFERENCE not a recommendation - but it took me days of contemplation to wrap my mind around that and I am in the business of studying such things - therefore - a lot of education is needed as we go forward with any of our labeling initiatives. If we are basing our daily values on a 2000 calorie diet, people must understand that if a product has 30% of daily value of total fat, it is likely to be 35% for their daily diet because they should most likely be eating LESS than 2000 calories a day.
0-10% - which brings us back to the sugar issue. As noted above, several respected organizations have indicated that added sugar need be limited. The WHO calls it free sugar and that makes good sense as added sugar is that included syrups, fruit juices and honey. In other words, the sugar isn’t anchored to a food - unlike the natural sugar in an orange which contains fiber as well as other nutrients the body needs. So sugar leads to obesity in as much as it leads people to over consume calories. The consensus is that added sugar be no more than 10 percent of a person’s daily calories. Either the CSPI or the AHA has indicated it be 8% of daily intake so let us not look at a 2000 calorie reference but a more reasonable 1800 calorie reference - in that case, 144 calories of sugar is the upper limit and that equals 36 grams or 9 teaspoons. If you drink one 12 ounce soda, you’re over.
IOM Phase One - in the report that was published, four nutrients are identified as being related to the diseases that most affect the majority of Americans. The diseases are heart disease, stroke, cancer and diabetes. The nutrients, and there subsequent place on any FOP system, are calories, saturated fat, trans fat and sodium. The report speaks to sugar but does not isolate sugar for the label. I am hoping that this will change. The IOM is very clear that the most critical factor in diet related disease is the CALORIE.
CVD - ironically this is another concept that makes total sense to me now that someone spelled it out - the top killers of Americans are heart disease, cancer and stroke - coronary heart disease CHD and cerebrovascular disease CVA are under the umbrella term CVD. The dietary factor that most increases ones risk for heart attack or stroke, i.e CVD, is blood cholesterol - or abnormal blood cholesterol called dyslipidemia. Dyslipidemia equates to one of three things: too high a level of low density lipoprotein, too high a level of triglycerides or too low a level of high density lipoprotein. The way to reduce blood cholesterol and dyslipidemia which can lead, which does lead to atherogenesis or plaque buildup is to eat less saturated and trans fatty acids. The IOM report notes that this is more important than avoiding foods high in cholesterol. The report also notes that Americans are consuming more than 10% of their daily calories from saturated fat sources when less than ten percent - even seven percent -is recommended (not TOTAL fat, saturated fat). It is suggested that a decrease in one percent of calories from sat fat can lower LDL by one to two percent.
Cancer - have to add this statement that was written in the IOM report but attributed to the World Cancer
Research Fund and the American Institute for Cancer Research who stated jointly in 2007 that the most important thing a person could do to prevent cancer was to maintain a healthy weight throughout their life time. (I suppose not smoking was in there as well). It is stated also that 1/3 of the cancers that occurred in 2010 were related to intake and physical activity.
Short Falls - we also have nutrients (calcium, Vit D, potassium and fiber) and food groups for which we are not getting adequate percent of value or calorie. For example, we should get more of our calories from fruits, vegetables and whole grains(not total grains, we over consume them, but whole grains) than we currently do - as a group. Most interestingly, one of the short fall groups noted by the IOM committee is fat free dairy!
There is so much more but let me end on this - recall a few days ago that I emailed Dr. Kelly Brownell at the Yale Center for Food Policy - he emailed back today - sending another article for me to read and letting me know that his research on food labels would be published soon
Sources:
Committee, D. G. A. (2010). Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans, 2010, to the Secretary of Agriculture and the Secretary of Health and Human Services. In U. S. D. o. Agriculture (Ed.). Washington, DC: USDA.
FDA. (2010). Front-of-Pack and Shelf Tag Nutrition Symbols; Establishment of Docket; Request for Comments and Information. washington DC: Food and Drug Administration Retrieved from http://www.federalregister.gov/articles/2010/04/29/2010-9939/front-of-pack-and-shelf-tag-nutrition-symbols-establishment-of-docket-request-for-comments-and#p-3.
IOM. (2010). Examination of Front-of-Package Nutrition Rating Systems and Symbols:. In E. Wartella, Lichtenstein, A., Boon, C. (Ed.), (Vol. Phase 1): Institute of Medicine.
Nishida, C., Uauy, R., Kumanyika, S., & Shetty, P. (2004). The Joint WHO/FAO Expert Consultation on diet, nutrition and the prevention of chronic diseases: process, product and policy implications. Public Health Nutrition, 7(1a), 245-250. doi: doi:10.1079/PHN2003592
Schneeman, B. (2009). Guidance for Industry: Letter Regarding Point of Purchase Food Labeling. college park, MD: Retrieved from http://www.fda.gov/Food/GuidanceComplianceRegulatoryInformation/GuidanceDocuments/FoodLabelingNutrition/ucm187208.htm.
Schor, D. R. D., Maniscalco, S. M. P. H. R. D., Tuttle, M. M. M. P. H. R. D., Alligood, S. M. P. H. R. D., & Reinhardt Kapsak, W. M. S. R. D. (2010). Nutrition Facts You Can't Miss: The Evolution of Front-of-Pack Labeling: Providing Consumers With Tools to Help Select Foods and Beverages to Encourage More Healthful Diets. Nutrition Today January/February, 45(1), 22-32.
Silverglade, B., Ringel Heller, I. (2010). Food Labeling Chaos. In C. f. S. i. t. P. Interest (Ed.), The Case for Reform. Washington DC: CSPI.
Van Horn, L., Johnson, R. K., Flickinger, B. D., Vafiadis, D. K., Yin-Piazza, S., & on behalf of the Added Sugars Conference Planning Group. (2010). Translation and Implementation of Added Sugars Consumption Recommendations: A Conference Report From the American Heart Association Added Sugars Conference 2010. Circulation, 122(23), 2470-2490. doi: 10.1161/CIR.0b013e3181ffdcb0
Calorie Count document
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