What do you think 'natural' means?

Remember past blog posts where I discussed the meaningless ‘all natural’ label declaration (see here and here, for example)? Well, it looks like enough people, or I should say, industries, have voiced similar concerns and with their clout, have moved this issue into the FDA action phase.

The FDA comments portal opens tomorrow and you can participate by clicking on this link.  The three main questions posed are:

Is it appropriate (for the FDA) to define the term “natural”?

If so, how should natural be defined (in regards to food/beverage products)?

How should the FDA determine if a manufacturer is using the term correctly on its food or beverage labels?

I have had two broad concerns with the labeling of an item as all natural (because that is the point of this, food companies want to boast a product as all natural, not just natural or containing natural ingredients). The first is that the term gives the product a ‘health halo’ that may not be justified. In other words, all natural just means all natural (except of course we don’t KNOW what that means). It does not mean health promoting, or nutrient rich, or low sodium/salt, or trans-fat free, or low calorie. None of the things that I want my purchases to be are described by the term natural - though I certainly want minimal processing. My second concern is within the parenthetical comment above- we don’t know what natural means! The old standard, but unenforced ethos from the FDA, was that it meant minimally processed, free of artificial dyes and such. That is far too subjective a definition. For something to be truly all natural, I believe it has to be a whole food, maybe it can contain preservatives, but surely it can’t come in a box. There are so many things that natural isn’t that I am of the mind that the word should NOT be allowed on any labels and thus it doesn’t have to be defined by the FDA. I think that is going to be my official comment. Instead of defining the term, I think that it should be banned from labels altogether.

What would your comment be? Speak up here… or the food industry will speak for you!

Update - 11/15/15 Oh my goodness, how could I have forgotten my favorite All Natural product - YES, peanut butter that isn't fortified or processed, that counts :)

Nutrition Labels: Calories and Sugar

I am a little disappointed in the scientific rigor of the two studies I mention below, especially because they address two issues of importance to me - and you; restaurant menu and food package labeling. The study designs/methods make it hard, no impossible, to make causal inferences.  We can't say x caused y, in either study - but to be fair, the second study was only meant to describe peoples perceptions.  Unfortunately, the people surveyed are not representative of the larger US population.

The first study (from the University of Glasgow in Scotland) compared the average weight gain of two different groups of college students - during two different years.  The first group may or may not have eaten at the cafeteria when no calorie labels were present and the second group may or may not have eaten at the cafeteria when calorie labels were present.  The first group gained 8 pounds during 36 weeks (perhaps a semester) and the second group gained 4 pounds during the 36 weeks they were assessed.  There is absolutely no way to say that the calorie labels were responsible for the weight gain differences - none.  And I am 100% pro labeling. However, during the second year when calorie labels were on the menus, the customers did purchase less calories than when the labels were not on the menus - during this one time period.  That is important.

The second study - a very small, internet survey- strove to answer the question of whether or not Americans would be confused by the addition of an added sugar declaration on the Nutrition Facts Panel (the panel on the back of packaged foods).  The rationale for this study was the assertion by anti- added sugar labeling folks that consumers would not find the additional nutrition information helpful - on the contrary, naysayers say - added sugar information will confuse the public.

The assertion that more information is bad really gets under my skin, because again, I am pro labeling.  However, there is evidence from studies on nutrition information that suggests we cannot apply available nutrition information in the context of our personal, daily needs.  That is why the IOM and others have recommended more intuitive labels, ones that highlight a few nutrients of concern, like salt, sugar and overall calories- in color coded front of the package schemas.

But the FDA is considering changes to the Nutrition Facts Panel(NFP) on the back, including an added sugar declaration - read more here.  Ted Kyle and his colleague surveyed a small group of internet users, a couple hundred, and asked them if the added sugar section of the NFP was helpful or confusing.  The survey respondents looked at a make believe label before answering the question.  Most of the people who participated said that the additional information was helpful.  I think this is probably right, however, the survey doesn't really tell us anything about what people will do when the labels actually contain this information, we need a different kind of study for that.

You can read a popular press write up about the Glasgow study here, and an over view of the added sugar survey results can be found here.  The ConscienHealth blog written/maintained by Ted Kyle focuses on more rigorous studies than the added sugar survey  and is one of my favorites.

Nutrition Labels: Chaos, Confusion and Coercion

As it turns out, the FDA didn't publish those final rules for menu labeling last month and the IOM didn't persuade the government to mandate new front of pack labels for packaged foods. Instead, there is a mix match of existing individual state and city menu labeling laws and states continue to send more bills on labeling to their legislatures.  Even the US Congress has a new restaurant menu labeling bill, which is attempting to rewrite the current law (the one not yet implemented or enforced).  In the new bill, lobbyists for convenience stores, entertainment venues and grocery retailers are trying to get their constituents or companies excluded from mandatory labeling.  I disagree with the entertainment venue exclusion, or any exclusion for an establishment selling foods without a label, e.g., a steam table at a grocery store or 7-Eleven.

With regard to packaged foods, I expected that the recommended update to the nutrition facts label would see years of delay, but I did not expect that a group would form to scare us into believing that being told the amount of calories and sugar in our food was a threat to our independence!  Seriously.  The group is called Keep Food Legal, because apparently full disclosure on the ingredients in the products we purchase is somehow paternalistic and threatens our individual liberties.

BTW, in more sugar news, the World Health Organization has updated its stance on limiting sugar intake (to reduce obesity and oral disease); they recommend no more than 5% of total daily calories from added sugar.  This is a little less than is recommended by the American Heart Association.  If you missed the blogpost where I introduced the sugar concerns generated from recent research, you can read it here.

Lastly, the Grocery Manufacturers Association is going full steam ahead with its Facts Up Front labels (and spending lots of money to do it).  The problem with industry front of pack labels and the individual city and state menu laws is that they are not standardized across products or states and do not necessarily have the information that is most important to us (e.g., some list total carbohydrates instead of grams of added sugar).  

That being said, I am starting to warm up to the industry sponsored front of pack food labels because I think they are the best we're going to get for a while. And the Facts Up Front labels list sugar grams and calories, which matter.  

That's my update on labels. The next blog will be about sedentary activity and why you and I should avoid it.

If you want more info on the food industry and labeling, I recommend a ConscienHealth blog post - access it here.

Would you like sugar with that label?

Since nutrition labels - on packaged foods and restaurant menus- are my passion, if I did not address today's FDA announcement in my blog post I imagine my readers would worry that something dreadful had happened to me.  I am here, busy, but not too busy to stop to make note of today's announcement.

So YES, I saw the announcement and I think it is a step in the right direction, but I have two big concerns.

1) You still have to pick up the package (and those you want to compare it with) and turn it around to see the info.
2) A proposal is NOT a law, and heck, even if it was, I wouldn't feel that much more encouraged.  Psst... FDA we are still waiting for those restaurant menu label rules.

There are also several things that are good in the proposal.
I love that it includes an Added Sugar amount, and this recent blog post explains why you should be glad, too.  It is also good that the label is going to emphasize, with bold lettering, the calorie amount and make serving sizes more reasonable (hmm, this sounds like the IOM recommendations for a Front of Pack label that never happened).  But wait, I should clarify - reasonable was the wrong word - very wrong word.  I meant realistic.  The new serving sizes will reflect what a person is likely to consume in one sitting, not what is calorically appropriate for them to consume.  Lastly I think it is good that the label will highlight the amount of vitamin D in a serving. Americans don't lack for much in their diets, but most do not get enough vitamin D.

I either agree with or am ambivalent about some of the other changes.  For example, I agree that we don't need to know the percent of calories that come from fat, but do need to know the amount of fat, especially by type i.e., TFA which is harmful and  saturated fat, which might be harmful.  I understand why the FDA suggests keeping the percent daily value, but I hope that in the end they will change what the 'recommended' average daily calorie amount is and emphasize that the average daily calorie amount may or may not be YOUR recommended amount.

Some food manufacturers are upset about the proposal and will fight to keep the changes from happening - they say its too costly, and I say, use some of the marketing money you spend so freely.  Otherwise or nonetheless, expect many of your products to start having less grams of sugar and less calories - YES!

Here is the sample label from the FDA and a link to the press release where this picture was originally posted.

 

See how the type of nutrition label impacts your understanding.

I have spoken of front of pack nutrition labels many times and provided examples of different systems.  A system can be one that appoints stars for meeting a certain criteria, or one that uses a symbol to denote healthiness, or my favorite, one that uses a multiple traffic light.  The multiple traffic light system shows whether the product is low, medium or high in amount of each nutrient most people should limit (i.e., sugar, salt, sat fat and calories).
The most important thing about a front of pack label is that it be standardized across all products, manufacturers and restaurants (if it goes to menu labeling).  Imagine how confusing it would be (and is now in the US) if each company decided what information, if any, to put on the front of a package.  
When it comes to making health and weight related dietary choices the most important disclosures are these: calories, sodium, sugar, and probably saturated fat. We need to be able to see the amount of these nutrients at a glance across items as we shop.  The traffic light system goes one better.  If the traffic light is used, a consumer does not have to do math or know the number of grams or milligrams that are recommended for any one nutrient in a daily diet.  The consumer just has to know that green is better (GO) and red should be limited or avoided (STOP).  In essence, a consumer can aim for mostly green and yellow.
The UK has begun its voluntary traffic light labeling program in grocery stores and it seems to be doing well.
When researchers and public health professionals were making the case for front of pack labels, they put together an on line quiz to test consumers understanding of nutrition labels.  It is still available, here.  I took it and suggest you do as well.  

Fit and Active (fit facts) The Right Front of Pack system?

   One of my classmates was eating a snack the other day and the package caught my attention.  I noticed that it had a front of pack label and that the back of the pack contained an explanation of the label system.  I did not recognize the brand of mini rice cakes.  I thought that the Quaker iced/frosted mini rice cake snacks had a new package and label.  I asked my friend if I could have her empty package.  I know, I am that weird.
   Turns out, the snack cakes were a store brand and the store has implemented this labeling across all its products.  It is from ALDI.  They refer to their scheme or system as Fit Facts.
   I am 100% in favor of a front of pack system or label that highlights nutrients that are important to consider in our diets.  Nutrients that we get too much of and should limit.  The problem is a lack of standardization over which nutrients should be highlighted.  The Institute of Medicine has given us some guidelines but the recommendations have not translated into rules - YET.  I wrote about them here, almost a year ago.
   The ALDI labeling, which you can see below does not make things clear for the shopper.  For example, the rice cakes package I 'borrowed' shows the amount in grams or milligrams(sodium) of four items.  I disagree with the inclusion of total fat because saturated fat is the item to limit and though three of the four show a percent daily value (which is suspect but helpful) the fourth SUGAR has no percent daily value because it has no daily value.  If the FOP system used was the multiple traffic light, the criteria would have each of those items as either red, amber or green. In the rice cake case, the sugar grams are 6.  That seems low right?  It's not.  The total weight of the package is 20grams.  That means that the product is 30% sugar.  The multiple traffic light (MTL) uses red to warn that a product is high in sugar if it contains as little as14% ! It is okay to eat this 90 calories and 6 grams of sugar, just don't tell yourself it is a low sugar product.
   The front of pack systems are needed and they can be helpful but  this label does not make it easy for you to know if something is "healthy."  We should not have to get out our calculators and divide 6 by 20 to get our percent of sugar!

The picture on the bottom left is the Front of Pack system.

 

NonDairy - Good Fat - No Sugar - Low Calories

   In my blog, I am more likely to make food 'group' recommendations than product recommendations - my most well known product rec being  Smuckers All Natural Peanut Butter. 
   Today I will share the labels of two products - two brands, in one category that I do highly recommend.  Almond Milk. There is a continuing controversy over dairy products, esp. milk and if you are not allergic to nuts, this is a fantastic alternative.  It is better for several reasons.
   The reasons are calories, sugar and fat.  Taste may not be among the plus factors, because I am  suggesting the unsweetened versions ONLY.  Please don't go for the sweetened as those just add sugar. However, using the almond milks in recipes, cereal and coffee as opposed to drinking it straight is what I have in mind.  It is really best not to drink our calories anyways.
   Below are two labels.  One brand doesn't break down their fat content but both of them have fat without saturated fat.  Therefore,  the grams are all GOOD fat.  Please understand, there IS good fat and you need it.  These products give you healthy fat with calcium and without sugar.  The calorie content is very low.  The calories are half that of the same serving size of skim milk (90c).  The serving size is NOT small - it is one cup.   BTW, whole milk has ~140 cals, 2% ~ 130s, 1% ~110s.  Full disclosure - almond milk pales in comparison to skim milk with regard to protein.  Still, protein is not one of the nutrients that Americans lack so you'll be fine.

This is Almond Breeze.  It has better amounts of Good Fat. 

This is  Silk Pure Almond - More Expensive but better Calcium Percentage

I use almond milk in my oat bran, my cake and cereal bar recipes, and when I make sugar free instant pudding.

Product Line - Label Alert

   I wish this post were an update on national menu labeling or standardized front of pack product labeling, but it is not.  I am still unaware of an expected date for action on either of these.  
   What I want to draw your attention to today is a potential "trick" label.  I have noted for your education that the words "all natural" or "natural" on a food label do not guarantee anything more than this: "minimally processed."  If you have a definition for minimally processed, its as good as any because the entire issue is cloaked in vagueness.  If you really want something that has limited processing (and you probably should) then buy fresh fruits and vegetables.  Hopefully, your chicken, fish and meat would not be processed, but don't take that for granted.  Read the label (e.g. chicken is often 'plumped' with salt).
   But those are not the tricks of which I speak today.  I refer to a product line.  Just because a group of products is named Wholesome Goodness does not mean that any of the items are good for you or healthy.  There are several criteria by which to measure, but you might consider the amounts of added sugar, sodium, Trans fats and saturated fat, as well as calories per gram (or serving size).    
   If you are buying tomato sauce for example, you may have Del Monte, Hunts, a value brand and Wholesome Goodness.  The trick is that consumers see Goodness and think it is the healthiest one.  That may or may not be true.  Don't be sold by names or label disclosures, read the ingredients and nutrition facts panel to make a better decision. 
   This is all we can do unless or until the FDA/USDA come up with a standardized symbol and criteria. I would not trust individual food manufacturers as their goal is to sell a product not to improve the quality of your diet.

This is just a product line, not an accredited line of healthy or low calorie products.