Natalia Hauck, a clinical dietitian at the University of Iowa Hospitals and Clinics, believes her patients could benefit from easier-to-read nutrition labels on packaging and containers.
“A lot of my patients are almost afraid to check labels,” she said. “They feel that they might not understand what they are looking for. But by making it easier to read, I think it will give them more confidence to know … it’s not something you need a nutrition degree for. It will break that barrier.”
That may happen soon. The Food and Drug Administration (FDA) is proposing changes on nutrition labels on food and beverage packaging to bring the information up to date with the latest research and to help people understand what they are eating and drinking. It will take public comment until June 2.
The updated information could especially be useful to Iowans and the rest of the Midwest, where obesity rates are among the worst in the country. Iowa is the most obese state among its seven neighbors, ranking third in the 12-state Midwest and 12th in the nation, according to the July 2013 study called “F is for Fat” by the Robert Wood Johnson Foundation and the Trust for America’s Health. The study found that Iowa’s adult obesity rate is 30.4 percent, up from 23.9 percent in 2003 and from 12.2 percent in 1990.
Iowa’s closest neighbors in Missouri, Kansas and Wisconsin barely do much better. In the rest of the Midwest only Indiana and Michigan rank worse, coming in eighth and 10th respectively nationwide.
In a 2013 survey for the Gallup-Healthways Well-Being Index Iowans said they do well in overall mental, emotional and physical health, but ranked 33 out of the 50 states in the healthy behavior category.
Figures like those prompted the Healthiest State Initiative , a privately-funded effort funded by Wellmark and backed by Iowa Gov. Terry Branstad with a goal of making Iowa the nation’s healthiest state by 2016.
The new nutrition labels, if approved, could help. The font size on the calorie display will be bigger, bolder and more prominent, and to ensure that consumers will not mistakenly think the fat-calorie number is the total calories, that line will be removed.
Hauck supports that change.
“Removing this (fat calorie) category will eliminate confusion, because some people might look at it and think that it is the total calories in the entire package,” she said.
If the FDA labeling proposals are approved, the food industry will be given some lead time to sell current inventory and print new labels.
Other label changes would include updates to calories, serving size, added sugars and other categories on the labels. Items like total fat, saturated fat and trans fat would remain on the label.
Hauck said saturated fats are the “bad fats” that raise your cholesterol and put you at risk for heart disease. The unsaturated fats, the “good fats,” are actually a bonus in the foods we eat, because they help lower cholesterol and prevent heart disease. Consumers need to know what type of fat they are getting rather than the total calories from fat, Hauck said.
Gerd Clabaugh, interim director of the Iowa Department of Public Health, said, “Nutrition can be confusing. If you are going to be a well-informed consumer, there is a lot to digest.” No pun intended, he added.
“It is clear that food labeling has become a very important part of how consumers get access to information about food,” Clabaugh said. “Anything that can be done to clarify or provide better information to consumers would be something we would certainly be supportive of, and that seems to be the intent of the FDA’s changes.”
Another change to be made is the serving size amounts. The new labels will require serving sizes to portray a more realistic quantity consumers take in.
Dr. Katherine Mellen, a health and nutrition lecturer at the University of Iowa, said this particular change can have a positive impact on habits leading to chronic diseases like diabetes or heart disease.
“Ice cream is a perfect example,” Mellen said. “A standard serving size used to be a half a cup. People saw the calories per serving and thought there are only a couple of servings in a pint of Ben & Jerry’s. When in fact, it was four servings, and not the two most people consumed in one sitting. Updating the serving size and making it much more evident how many servings per container there are can definitely be helpful for portion control.”
Another major change to the updated labels will be the distinction of added sugars. Separating out the added sugars from the natural sugars will give consumers more perspective on what the food manufactures put in food.
A cup of milk, for example, has 12 grams of sugar. “That is not added sugar,” Mellen said. “That is lactose, which is the carbohydrate source in milk. You are also getting potassium, protein and vitamin D.
“If you have 11 grams of added sugar in a product, you are not getting any of those other nutrients that come from naturally occurring sugars.”
The World Health Organization announced in the beginning of March that it is cutting the sugar recommendation in half. It will now be 5 percent of total calorie intake instead of the current 10 percent. That comes down to about one soda per day.
Potassium and vitamin D will also replace vitamin A and calcium as nutrients required to be listed on the label. The 2010 Dietary Guidelines for Americans released by the USDA found these two nutrients most lacking in the American diet.
Michael Teague, a University of Iowa professor of leisure studies, said that while the new labels will aid consumers overall a dark side to the changes exist, too.
“Changing food labels will cost food manufactures well over $2 billion to switch to the new format, and their bottom line is profit margin,” Teague said. “This means the food manufactures are going to pass along the cost to the consumer.”
With that in mind, consumers could be faced with smaller sizes for the same retail price or the same sized products for a higher price. (See accompanying story)
The Iowa Department of Public Health has a program for giving Iowans with lower income levels access to nutritional food sources. The program, a special supplemental nutrition program for women, infants and small children, sometimes referred to as WIC, reaches 67,000 people a month.
More than 20 years have passed since any changes have been made to the nutrition labels.
Mellen said the timing stems from updates made to MyPlate, a visual online tool that helps individuals build a well-balanced meal with the five major food groups.
“MyPlate came out of the 2010 Dietary Guidelines,” Mellen said. “The food labels were really the last component that needed to be consistent with the other nutrition messages the government is giving us.”
She said many of the most nourishing foods do not require a label.
“Increasing our intake on fruits and vegetables is something that all Iowans can benefit from,” Mellen said. “Our best approach is to find a good balance between the foods that do have labels and the ones that don’t.”
Clabaugh said changing the labeling is a good start but not enough. “A focus on nutrition labeling alone is not going to get you to exercise. It takes a balance to be fully healthy,” he said.
The Food and Drug Administration’s task at hand is challenging, Clabaugh said. “We are talking about all Americans trying to make sense of what these labels mean. We are talking about various levels of education and understanding,” he said,
“It is a complicated science that has to be turned into a tool for nutrition labels for all consumers.”