IOM Proposes Simpler Front-of-Package Nutrition Rating System

The report concludes that it is time for a move away from front-of-package systems that mostly provide nutrition information on foods or beverages but don’t give clear guidance about their healthfulness, and toward one that encourages healthier choices through simplicity, visual clarity, and the ability to convey meaning without written information.

Oct 21 2011 --- A variety of nutrition rating systems and symbols are now on the front of food packages meant to make it easier for consumers to make healthful choices. However, the number and variety of nutrition rating systems in grocery stores today often lead to confusion in the grocery aisle, especially when consumers are pressed for time and may not understand a product rating system.

Congress to directed the Centers for Disease Control and Prevention to undertake a study with the IOM with additional support provided by the Food and Drug Administration and the Center for Nutrition Policy and Promotion in the U.S. Department of Agriculture. The task was split into two phases. A first report analyzed the nutrition rating systems and the scientific research that underlies them and was released in 2010. This second report delves into consumer use and understanding of front of package systems.

The report concludes that it is time for a move away from front-of-package systems that mostly provide nutrition information on foods or beverages but don’t give clear guidance about their healthfulness, and toward one that encourages healthier choices through simplicity, visual clarity, and the ability to convey meaning without written information. The report recommends that the Food and Drug Administration develop, test, and implement a single, standard FOP symbol system to appear on all food and beverage products, in place of other systems already in use. The symbol system should show calories in household servings on all products. Foods and beverages should be evaluated using a point system for saturated and trans fats and sodium, and added sugars. The more points a food or beverage has, the healthier it is. This system would encourage food and beverage producers to develop healthier fare and consumers to quickly and easily find healthier products when they shop.

The committee recommends that the FDA and the USDA develop, test, and implement a single, standard FOP system to appear on all products, replacing any existing system. The system should have the following characteristics:
• One simple, standard symbol translating information from the Nutrition Facts panel (NFP) on each product into a quickly and easily grasped health meaning, making healthier options unmistakable
• Displays:
• Calories in common household measure serving sizes (shelf tags to be used on bulk items such as fruits and vegetables as well as packaged goods)
• Zero to three nutritional “points” (for saturated and trans fats, sodium, and added sugars)
• Appears on all grocery products, allowing consumers to compare food choices across and within categories (determination for universal implementation of the symbol system must be preceded by consumer testing and conducted in conjunction with education and promotion program)
• Appears in a consistent location across products
• Practical to implement by being consistent with existing nutrition labeling regulations
• Integrated with the NFP so that the FOP symbol system and the NFP are mutually reinforcing
• Provides a non-proprietary, transparent translation of nutrition information into health meaning
• Made prominent and useful to consumers through an ongoing and frequently refreshed program of promotion integrating the efforts of all concerned parties

For products not meeting the eligibility and qualifying criteria for an FOP symbol, the system should display calorie and serving size information.

According to the report, calories in household servings should appear on all products. Saturated and trans fats, sodium, and added sugars should form the basis of the symbol system. The committee developed an approach to evaluate saturated and trans fats, and sodiumnutrients strongly associated with the most pressing diet-related health concerns, and added sugars, which the 2010 Dietary Guidelines for Americans recommends that consumers reduce or avoid. The criteria for evaluating nutrients for the system should be transparent and non-proprietary and should be based on widely available evidence.

The committee’s process for evaluating these nutrients in an FOP system occurs in two steps:
1. Eligible or not? If a food or beverage contains any one of the critical nutrients in amounts above a threshold limit, the product is not eligible for earning FOP “points” an indicator of whether a critical nutrient met defined criteria.
2. If eligible, for how many points? A product that is eligible is evaluated for FOP points for saturated and trans fats, sodium, and added sugars based on qualifying criteria that assess amounts of the nutrient. If one, two, or all three nutrients are present in a small enough quantity to meet the qualifying criteria, the product earns one, two, or three FOP points, respectively. For example, 100 percent whole wheat bread could earn all three points, gra¬ham crackers could earn two points for fats and sodium, and an oat and peanut butter bar could earn one point for sodium. The more points earned, the more a product helps con-sumers avoid harmful amounts of these nutrients, which have been linked to obesity, dia¬betes, and high blood pressure among other illnesses.

CSPI Executive Director Michael F. Jacobson responded to the proposal, “The Institute of Medicine’s proposal is eminently sensible—and will probably be roundly condemned by food manufacturers. A simple icon with 3, 2, 1, or zero check marks would give shoppers at-a-glance information about nutritional booby traps lurking inside packaged foods.The IOM’s proposal is far preferable to the voluntary “Facts Up Front” labeling program that the grocery industry is rushing to market. The industry hopes to preempt more consumer-friendly requirements by the FDA. The industry’s complex scheme requires consumers to consider the amounts of calories and four to six nutrients, without any numerical score or useful symbols to convey a food’s nutritional value. It is worth noting that the IOM’s approach, like all of the systems yet developed, still has holes that the FDA would have to address. For instance, it gives no consideration to foods’ vitamin, mineral, fiber, or protein content. Also, white bread, whole wheat bread, broccoli, artificially sweetened soft drinks, and artificially colored and flavored diet Jell-O would all have top scores of 3. Still, the FDA should promptly assign a task force to develop a mandatory front-of-package labeling regulation based on the IOM’s advice.”