Food Policy

Nutrition Labeling: Time for Change is Now

The Nutrition Facts Panel

The nutrition facts panel is a sorely underused bevy of information for consumers.  It is something that I regularly counsel clients on how to use as a tool and how to apply their individual needs to the information on the panel to make balanced decisions at the point of purchase.  It can be overwhelming to apply at first, but hopefully with some changes to make the label a bit easier to understand, the habit of using labels to impact consumer decision-making will become more routine.

Check out the press release from the FDA regarding the changes: FDA proposes updates to nutrition facts label on food packages 

What's Changing?

  • Serving Sizes and Calories are going to be more reflective of what people are actually eating and more prominently displayed
  • Added Sugars are going to be added to the label under the Sugars (under Carbohydrates) to clearly identify sugars that are not naturally occurring
  • Vitamins A and C are out, Vitamin D and Potassium is in as there are rarely deficiencies in the former, and the latter play larger roles in the development of chronic disease

Other Ideas?

First of all, the comment period is open right now regarding the proposed changes.  If you are interested in making a comment (I made mine!) please visit the following sites:

The Center for Science in the Public Interest (yes, love them!) has been on the forefront of this issue for years now and had come up with an interesting proposal regarding the changes.  See page 10 of this report for the best visual and explanation.  Personally, I prefer their changes to the current changes proposed by the FDA, but I understand that that would require a huge overhaul.  Not only is the FDA careful to not make major changes for fear of further confusing consumers, but many manufacturers are very resistant to these changes.

I honestly feel that the big change that is missing is requiring all sources of sugars to be listed together in the ingredients list to open up consumers eyes to just how haphazardly and insidiously processed sugars are added into the food supply.  I feel that adding them to the label as added sugars is a step, but unfortunately I'd bet we're going to find food manufacturers going the 'route of trans fats' and keeping the limits per serving just low enough to be able to label them as 0g.  There is also no reference for the consumer, so listen up!  The American Heart Association recommends no more than 24 grams daily for women and 36 grams daily for men.

Nutrition Policy In the News

 

Big Gulp

The New York City of Department of Public Health put into effect this month a new effort to decrease consumption of added calories from sugary beverages.  Beverages contaning sugar must be sold in servings of 16 ounces or less.  Water and "diet" drinks may be sold in larger quantities.  Research has linked larger portion sizes, plate sizes, and utensil sizes with an increase in caloric consumption.  Subsequently, as the standard cups and plates that fill our cabinets have grown, so have our waistlines. 

Arsenic in Rice

The Food and Drug Administration has an ongoing study regarding arsenic in rice consuption for 1200 products.  Consumer Reports recently put out an article that has raised public attention to this issue.  Rice absorbs trace amounts of arsenic in its natural growing conditions because it is grown in groundwater.  The FDA has found no evidence thus far that causes concern for the level of contamination (1 gram arsenic per 115,000 servings of rice) however they will be completing the study and releasing their final results and a new standard at the end of this year.  Organically grown rice and rice products are proving to have lower levels than inorganically grown.  At this point the take home message remains to moderate rice products in the diet.  Registered Dietitians are also encouraging use of organic products with babies and children as we find that children are susceptible to increased per-kilogram consumption of added chemicals.

 

Public Policy Initiatives That Work

Public Health Strategies for Health  Photos from two separate public health campaigns.

As some or most of you may know, I have always taken a keen interest in public policy (including helping to research and write sodium legislation for MA DPH during grad school!).  I feel that we live in an obesogenic environment and that one of the places to start to change that is through writing policy.  Creating communities that have access to healthful choices and the knowledge to make those choices is very important.

"As a society, we must implement evidence-based, cost-effective public-health interventions without delay -- we now know they work," said Mozaffarian, associate professor of medicine and epidemiology at Brigham and Women's Hospital and Harvard Medical School in Boston.

 

The Most Successful Campaigns

Researchers published in the journal Circulation analyzed over 1,000 studies seeking to tease out the most effective strategies.  Some that made the list are as follows, in no particular order:

 Bans on smoking in public (not to mention the taxing as a financial disincentive)

  • Walkable communities
  • Limitations on advertising unhealthy foods to children
  • Economic incentives that make healthy foods more affordable
  • Direct mandates and restrictions on specific ingredients (ex. trans fats, sodium)
  • Financials incentives for supermarkets to move into food deserts
  • In-school gardening and structured physical activity in school systems

So what are some of the best and worst public health campaigns that you can think of?  Is anyone thankful for or angry about some of them?  I'd love to know your responses..

----

For any additional information regarding global initiatives, please visit the World Health Organization's Strategy on Diet, Physical Activity and Health

Falsified Calorie Information?

The Calorie-Menu Debate

New York City instituted a law that requires restaurants to put the calorie content of their foods on the menu.  Since its inception almost a dozen other cities have done the same, and legislation is being considered in the Senate to create national policies instead of leaving it up to local governments.  NYC decided to place calorie content prominently on their menus in an attempt to inform customers, and hopefully eventually slow down the growing rates of obesity, heart disease, and diabetes.  

Dishonesty.

A recent study by Scripps Research Institute brought many of those NYC menu items to independent labs to determine the calorie content of random items.  Each item was tested twice by different labs.  The study found that the calorie counts being reported on the menus did not reflect the numbers found by the laboratories.  Instead, the menus often showed a number lower than those found.  This has been highlighted by an article in the Wall Street Journal.  How are we supposed to make informed decisions if the restaurants aren't meeting us halfway with honesty?  

According to NPD Group, one in five meals or snacks consumed in the U.S. are produced by restaurants, and 59% of restaurant traffic is at chains.  - WSJ Article

With dining out the norm and not the exception, I think it is very important that people have access to the caloric information.  I don't think that means it needs to be displayed on the menu that is handed to you in the restaurant.  However, having the ability to look that up can help people manage any current diseases or conditions, deal with food allergies and intolerances, and possibly stave off unwanted caloric intake.  

 Photo courtesy of Taylor Umlauf with the Wall Street Journal

What Do You Think?

Setting this law into stone nationally is not the answer to the trend of our growing waistlines in this country, but do you think it is a step in the right direction?  Where would you like to see this information displayed?  And do you think it affects your choices in selecting foods to eat at restaurants?  

You Eat What You Are?

Nutrigenomics

Nutrige-what?!  A very slowly growing field that is sparking quite some interest is nutrigenomics.  Nutrigenomics studies how genetic and cellular processes affect nutrition and health.  While this arena is still in its infancy, it strikes a chord with people for its potential to completely personalize the field of nutrition.  Ever since the Human Genome Project was completed in 2003, all sectors of the medical industry have been interested in the newly visible relationship between individual genes and disease markers.  Could the field of nutrition be the next to join the ranks of genetic testing?

Epidemiological Data

A majority of the nutrition recommendations currently made for people are based on population and epidemiological data.  While these numbers (based on probably thousands of validated studies in peer-reviewed literature) provide a rough outline, it begins to make the field of nutrition quantifiable.  Do you know how many calories are in a pound?  Maybe.  Do you know how many calories your body burns while eating, sleeping, and walking around?  Probably not.  But do you know a range of calories that is healthy for you to consume each day?  Most likely.  That's because food labels, doctor's recommendations, and personal research regarding weight management and health throw this information at you first and foremost.  It is based on large scale studies, but it provides you with an idea of what might work.  Quick and easy to understand, and you can adjust your diet from there to fit your personal needs.

Photo courtesy of Impact Lab

Genetic Testing to Determine Diet?

Right now both here and in Europe we seem to be a ways off from this (probably largely because the research to support how to go about reading the results just isn't up to speed yet).  The field is at a standstill as nutrigenomics research is not getting a lot of funding and the ethics questions are too complex to begin answering.  The NCMHD Center for Excellence in Nutritional Genomics is pushing for using this research to eliminate racial and ethnic health disparities, understand environment-gene interactions and to incorporate genomics into a multidisciplinary approach to individual healthcare. 

I think nutrigenomics is a fascinating field that quite simply isn't well understood [yet].  Imagine knowing what diseases you are genetically at a higher risk for (no more guessing based on family history, ethnicity, and age).  Knowing this information years ahead of the diagnosis could in fact help motivate individuals to alter their diet for prevention.  It could also go the other way, with a patient resigning themselves to a future disease state.  The human psyche is incredibly variable.

Designer Diets instead of Designer Drugs

Personalization is a key word in health care.  When it comes to our health we like to know that any and all steps taken will improve our bodies.  While the jury is still out on whether this is a viable step towards preventative care or not, I'd like to know what you think!  Would you want a genetic test at the doctor's office next time you go in?  Based on those results would you meet with a dietician?  If your genetic testing comes back with clean results would you be less motivated to eat healthfully and exercise frequently?  

Thank you to April for asking about the current state of nutrigenomics and prompting me to write about this.  I've realized that I have more questions now after reading up on the latest research than I did before, just knowing a tiny bit about the field.  The field inherently raises complex questions.  Be sure to keep an eye out to see how this field progresses over the next few years!  It just might enter the public policy and health care reform debate...

What Does Organic Really Mean?

What is Organic?

There is a constant debate regarding the importance of organic products, what that label actually means, and what benefits are derived from changing our diets to include organic foods.  The organic industry is worth $23 billion and is growing at a rapid pace.  

Every major food company now has an organic division. There's more capital going into organic agriculture than ever before. - Michael Pollan

Organic is a term used for food and produce grown and produced without the use of pesticides, synthetic modifiers, genetic modifiers, or ionizing radiation, and for animals raised without antibiotics and growth hormones.  

USDA OrganicPhoto courtesy of organic.org.

The USDA Organic label (shown here)  is one way that you can look out for organic products.  For single ingredient products this will be a sticker or seal directly on the product.  For multiple ingredient products there are several tiers of organic.  

100% Organic - Foods made with all organic ingredients.

Organic - Foods contain 95-99% organic ingredients by weight.

Made with Organic Ingredients - Foods contain 70-94% organic ingredients.  These products do not bear the USDA Organic seal but may list up to three organic ingredients on the front of the package.  

Other - Foods contain <70% organic ingredients.  These products may only list organic ingredients on the nutrition information panel of the packaging.  

Things to Keep in Mind

Use of the USDA Organic seal is voluntary even if a producer is certified organic.  While this is not a common practice, reading the nutrition label is the only way to know the extent of organic ingredients in a product.  

On the other hand, becoming certified organic is a costly process and many small farms cannot afford to go through it.  This means that if you buy produce from a farmer's market or a store that supports local agriculture they may not be certified organic but may use organic practices.

Controversies

The USDA Organic label has come under fire recently.  Lobbyists have been getting their way with lawmakers to broaden the regulations regarding organic products, allowing more chemicals to fall under the "organic" umbrella, in turn allowing companies to use the organic seal on products that may not be truly organic.  In addition, components to the original organics law have been made optional for companies, such as annual pesticides testing.  Should we consider this a means to an end?  Soft regulations exist as organics become mainstream, [hopefully] only to be tightened up as people speak up for their rights?  Or is this the direction organics is going to take?  "Organic" may not really be organic, while consumers believe they are getting healthy and safely grown food.  

It's a very confusing world to navigate, and the face of organics is constantly being debated and manipulated by lawmakers, consumers, farmers, supermarkets, and food conglomerates.  Hopefully as the market continues to grow we'll slowly figure it out.  

The ultimate goal in this country surrounding food and nutrition isn't necessarily that all consumers make the same food decisions (organic vs. non-organic, fast food vs. slow food) or even that they always make healthy decisions, but rather that they make informed decisions.