• On May 20, 2016 the FDA mandated an important update for the Nutrition Facts Label.
• This represents a very significant change for the more than 20 year old nutrition label and for the first time will include information on added sugars and provide more realistic information portion sizes.
• Health professionals believe the update will make it easier for more people to optimize their nutrition — a critical part in a healthy lifestyle.

 After 20 years

The U.S. Food and Drug Administration took a major step in making sure consumers have updated nutritional information for most packaged foods sold in the United States that will help people make informed decisions about the foods they eat and feed their families. More than 20 years ago, the first nutrition labels on food packages was a major battle and only with the endorsement of the first President George Bush was a major victory for public health possible. On the occasion of the first label update in 20 years, First Lady Michelle Obama, a champion of healthy nutrition was quoted “I am thrilled that the FDA has finalized a new and improved Nutrition Facts label that will be on food products nationwide — his is going to make a real difference in providing families across the country the information they need to make healthy choices.

Opinions and facts

Needless to say the sugar industry said it was “disappointed” by the FDA’s decision to require a separate line for added sugars and went on to say that they “are concerned that the ruling sets a dangerous precedent that is not grounded in science, and could actually deter us from our shared goal of a healthier America. We will see if there is a threatened legal attempt to derail the FDA decision.

The scientific evidence that hidden and added sugars — so common in processed foods, are a significant factor in the epidemic of obesity and diabetes was a driving concern that more transparency in food labeling was needed. For the first time added sugars will be present on the Nutrition Facts. A 12-ounce can of Coke has 140 calories and 39 grams of sugar, which is about the equivalent of 9 teaspoons and exceeds the recommended amount of added sugar per day of less than 10% of total calories — first recommended by the American Heart association in 2009. The World Health organization went further and in 2014 recommended a more aggressive limit of added sugars to less than 5%.  and called sugar “as the new tobacco.” The updated nutrition label will give Americans a much better opportunity to track added sugars and make informed nutrition choices.

A calorie is not just a calorie

The food industry favors added sugar for its palatability especially in non-fat and low-fat items and for better shelf life. Increases in fructose consumption (HFCS) in the United States have paralleled the increasing prevalence of obesity. High consumption of processed foods and sugary beverages account for much of the increased dietary fructose in the American diet and is an important factor promoting weight gain and insulin resistance -the condition fueling the epidemic of diabetes. It is true both fructose and glucose have 4 calories per gram but it is the metabolic fate of fructose that is so different from that of glucose. Not only do we as a nation unwittingly consume too much sugar the science tells us that excessive fructose causes more metabolic mischief than glucose. It is no longer true that a calorie is a calorie is a calorie -despite what the sugar lobby says.

Appetite control is blunted by fructose unlike glucose which is more likely to increase fullness (satiety). Researchers believe that fructose consumption is less likely to be associated with “feeling full” and may promote “over-consumption” and unwittingly increase an individual’s caloric consumption.  Fructose unlike equal caloric amounts of glucose can increase the risk of fatty liver disease (fructose turns on what we call de novo lipogenesis). Fatty liver or non-alcoholic liver disease (also known as, NAFLD) represents a worldwide health concern and a leading cause for cirrhosis. Too much sugar and fructose specifically can increase uric acid, blood pressure and increased pre-diabetes (metabolic syndrome) and type 2 diabetes -all directly linked to an increased risk of cardiovascular disease.

For more than 20 years, Americans have relied on the Nutrition Facts label as a leading source of information regarding calories, fat and other nutrients. According to the recently appointed FDA Commissioner Robert Califf, M.D.,

“The updated label makes improvements to this valuable resource so consumers can make more informed food choices — one of the most important steps a person can take to reduce the risk of heart disease and obesity.”

Nutrition label updates

• Most food manufacturers will be required to use the new label by July 26, 2018. Manufacturers with less than $10 million in annual food sales will have an additional year to comply with the new rules. The following obtained from the FDA website are many of the important changes to look for:
• An updated design to highlight “calories” and “servings,” two important elements in making informed food choices.
• Requirements for serving sizes that more closely reflect the amounts of food that people currently eat.
• Declaration of grams and a percent daily value (%DV) for “added sugars” to help consumers know how much sugar has been added to the product. It is difficult currently to meet nutrient needs while staying within calorie limits if you consume more than 10 percent of your total daily calories from added sugars, and is consistent with the scientific evidence supporting the 2015-2020 Dietary Guidelines for Americans.
• “Dual column” labels to indicate both “per serving” and “per package” calorie and nutrition information for certain multi-serving food products that could be consumed in one sitting or multiple sittings. Examples include a pint of ice cream and a 3-ounce bag of chips. With dual-column labels available, people will be able to easily understand how many calories and nutrients they are getting if they eat or drink the entire package/unit at one time. For packages that are between one and two servings, such as a 20 ounce soda, the calories and other nutrients will be required to be labeled as one serving because people typically consume it in one sitting.
• Updated daily values for nutrients like sodium, dietary fiber and vitamin D, consistent with Institute of Medicine recommendations and the 2015-2020 Dietary Guidelines for Americans.
• Daily values are reference amounts of nutrients to consume or not to exceed and are used to calculate the %DV that manufacturers include on the label.
• Declaration of Vitamin D and potassium that will include the actual gram amount, in addition to the %DV. These are nutrients that some people are not getting enough of, which puts them at higher risk for chronic disease.
• The %DV for calcium and iron will continue to be required, along with the actual gram amount. Vitamins A and C will no longer be required because deficiencies of these vitamins are rare, but these nutrients can be included on a voluntary basis.
• “Calories from Fat” will be removed because research shows the type of fat is more important than the amount. “Total Fat,” “Saturated Fat,” and “Trans Fat” will continue to be required.
• The FDA is also making minor changes to the Supplement Facts label found on dietary supplements to make it consistent with the Nutrition Facts label.

Summary

The changes in the FDA nutrition label -the first major change in 2 decades will hopefully be seen in the next 2 to 3 years and holds the promise to help consumers make more informed and healthful choices in their nutrition. Public health policy continues to evolve and has been controversial. Some food manufacturers, for instance, continue to argue that the inclusion of added-sugars (a major change in the food label) lacks scientific justification. The facts linking over consumption of added sugar and sugar-sweetened drinks to poor health are nevertheless, compelling and are a major public health priority.

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