Do nutrition labels confuse you?

 

Nutritional labels have been around for well over a decade, and the familiar panel — which provides some key nutrition information, an ingredient list and nutrition declarations — enables more informed food decisions.

Do people make good use of the information? The first step is for people to bother looking at it -- and they do. Women more than men, health conscious and exercise enthusiasts more than couch potatoes, but most people report they do consult with the label, at least when they’re buying a product for the first time. A recent review of 120 studies of nutrition label usage in Public Health Nutrition finds that 75% of Americans check the label.

Eyeing the label is a good start, but do consumers get what they need from it?

A recent paper in Nutrition Reviews found that of the 60 percent of consumers who said they use the Nutrition Facts Panel, only a quarter found it easy to use. The calorie information on the Nutritional Facts Panel gets a glance from 75 percent of consumers, but most consumers cannot put the calorie count in context since they have no idea how many calories they should consume, and about half of the people overestimate their suggested daily caloric intake. The percent daily values, typically located above the actual ingredients, were either ignored or poorly understood by most surveyed.

A ‘D’ in label comprehension

A new study in the journal Appetite studied 120 young Israeli adults’ understanding of the various parts of the nutrition label. The study was performed in a travellers’ immunization clinic, so it’s by no means a representative sample of the population, but rather a group of highly schooled, mid to upper socio-economic class individuals.

People were presented with several common food products, and were asked about their attention to and understanding of the nutrition facts on the label.

Most of the people (almost 80 percent) reported that they looked at nutrition labels when selecting foods.

But when given a label comprehension evaluation, the average score was a ‘D’ – 60 percent correct answers.

The nutritional table was understood much better than the ingredient list or the nutrition declaration information. For instance, when asked about red “Bamba”, most participants replied it did not contain food coloring, although the ingredient list says it does -- Bamba uses natural food color. (Bamba, a corn peanut snack, is perhaps the strongest food brand in Israel. It’s perceived almost as a weaning food, and is said to be the third word an Israeli baby attains – right after “mom” and “dad”.) The nutrition declaration piece, with its “without”, “contains no” and “less” assertions was least understood. When a bottle of canola oil declares it contains “no cholesterol” does it mean there’s naturally no cholesterol, or that this manufacturer kindly removed the cholesterol for added nutrition value?

Figuring out food labels

The nutritional label is an important tool for promoting healthy eating. Reading the label helps consumers decide if, and how much, of that packaged food they should eat.

Some of the nutrition confusion can be solved by nutrition education – of which there currently is very little. Not all people know that ingredient lists, by law, have to list ingredients by their relative amount in the product, from high to low, so fruit as the first ingredient is very different from fruit at no. 5, and that added sugar comes has so many different names. The people in the Israeli study thought they understood the label much better than they actually did – they didn’t know they didn’t know – and that overconfidence hinders further learning.

The nutrition label could also be more consumer friendly. Most studies suggest that readability (larger fonts please!) and clarity could be much improved. There are many suggested simple, visual symbols such as the traffic light symbol, that attempt to give a nutrition-in-a-nutshell view on the front of the panel. Each system has its supporters and detractors. Recently, the Institute of Medicine advocated that the front of the package panel display only four nutrition facts: calories, saturated and trans fat, sodium and sugars. It recommends that the FDA develop a point system -- much like the energy star® program used for assessing electronics’ energy efficiency – which takes into account just saturated and trans fats, sodium, and added sugars, since these nutrients pose the most pressing diet-related health concerns.

To increase the mix-up, manufacturers introduce some more confusion in an effort to better market their product. The declaration “no cholesterol” on a vegetable oil is redundant – no vegetable oil has any cholesterol, as cholesterol is present only in animal derived foods. Likewise, package health claims promising “immunity” “antioxidants” "heart-health" “strong bones” and “lower cholesterol” don’t mean the food is healthy.  They practically don’t mean a thing.

So how to read the label? For an FDA tutorial on how to read the Nutrition Facts label go here, and I’d love to hear your personal approach.

Dr. Ayala