(EDITORIAL NOTE: Although AthleteInMe.com® is not a nutrition resource per se, we felt that the following information would be useful to athletes and others who exercise, for example, when reading the labels for energy bars or sports drinks. In addition, new changes to food labels went into effect on January 1, 2006. Resources used to compile the information in the following review are listed below.)

Under regulations from the FDA and the Food Safety and Inspection Service of the USDA, nutrition labeling is required for most foods. Voluntary nutrition information is also available for many raw foods: the 20 most frequently eaten raw fruits, vegetables and fish each, under FDA's voluntary point-of-purchase nutrition information program, and, under USDA's program, the 45 best-selling cuts of meat.

HISTORY

The evolution of food labels can be traced back to the 1970's when then-FDA commissioner David Kessler, JD, MD, required that orange juice manufacturers be truthful regarding their use of the word "fresh".

In 1990, the Nutrition Labeling and Education Act (NLEA) was passed. FDA's rules for food labels implement the provisions of NLEA, which, among other things, requires nutrition labeling for most foods (except meat and poultry) and authorizes the use of nutrient content claims and appropriate FDA-approved health claims.

Today, food labels provide nutrition information about almost every food in the grocery store:

• information on the amount of saturated fat, cholesterol, dietary fiber, and other nutrients of major health concern
• nutrient reference values, expressed as % Daily Values, that help consumers see how a food fits into an overall daily diet
• uniform definitions for terms that describe a food's nutrient content -- such as "light," "low-fat," and "high-fiber" -- to ensure that such terms mean the same for any product on which they appear
• claims about the relationship between a nutrient or food and a disease or health-related condition, such as calcium and osteoporosis, or, fat and cancer. These are helpful for people who are concerned about eating foods that may help keep them healthier longer.
• standardized serving sizes that make nutritional comparisons of similar products easier
• declaration of total percentage of juice in juice drinks. This enables consumers to know exactly how much juice is in a product.

"NUTRITION FACTS" PANEL (ie., "The Label")

On the "Nutrition Facts" panel, manufacturers are required to provide information on certain nutrients. The required nutrients were selected because they address today's health concerns. They are listed below, in the order in which they must appear on the label. This order reflects the priority of current dietary recommendations. (Mandatory components appear in bold font):

• total calories
• calories from fat
• calories from saturated fat
• total fat
• saturated fat
• trans fat**
• polyunsaturated fat
• monounsaturated fat
• cholesterol
• sodium
• potassium
• total carbohydrate
• dietary fiber
• soluble fiber
• insoluble fiber
• sugars
• sugar alcohols (mannitol, sorbitol, xylitol)
• other carbohydrates (the difference between total carbohydrate and the sum of dietary fiber, sugars, and sugar alcohols, if declared)
• protein
• vitamin A
• percent of vitamin A present as beta-carotene
• vitamin C
• calcium
• iron
• other essential vitamins and minerals

(**trans fat became a required element of the food label on January 1, 2006)

If a claim is made about any of the optional ingredients, or if a food is fortified or enriched with any of them, nutrition information for these components becomes mandatory.

These mandatory and voluntary elements are the only ones allowed on the Nutrition Facts panel. The listing of single amino acids, maltodextrin, calories from polyunsaturated fat, and calories from carbohydrates, for example, may not appear as part of the Nutrition Facts on the label.

Ingredient Labeling

"Ingredients" are not the same as "nutrients".

Ingredients must be declared on all food products that have more than one ingredient. Because people may be allergic to certain additives, the ingredient list must include, when appropriate:

• FDA-certified color additives, such as FD&C Blue No. 1, by name
• sources of protein hydrolysates, which are used in many foods as flavors and flavor enhancers
• declaration of caseinate as a milk derivative in the ingredient list of foods that claim to be non-dairy, such as coffee whiteners

NUTRITION PANEL FORMAT

All nutrients must be declared as "percentages of the Daily Values" which are label reference values. The actual amount, in grams or milligrams, of macronutrients (such as fat, cholesterol, sodium, carbohydrates, and protein) are still listed to the immediate right of these nutrients.

Listing amounts as a percentage of the Daily Values is intended to prevent confusion that the "size of a number" can create. For example, a food with 140 milligrams (mg) of sodium could be mistaken for a high-sodium food because 140 is a relatively large number. In actuality, however, that amount represents less than 6% of the Daily Value for sodium, which is 2,400 mg.

On the other hand, a food with 5 g of saturated fat might be viewed as containing a low amount of fat. In fact, that amount represents one-fourth the total Daily Value because 20 g is the Daily Value for saturated fat.

Specific options for packages with less than 40 square inches and packages of less than 12 square inches of label space are also established. If manufacturers wish to provide nutrition information on these smaller packages voluntarily, they have several options: (1) present the information in a smaller type size than that required for larger packages, or (2) present the information in a tabular or linear (string) format.

DEFINITIONS

Serving Size: NLEA defines serving size as the amount of food customarily eaten at one time. The serving sizes that appear on food labels are based on FDA-established lists of "Reference Amounts Customarily Consumed Per Eating Occasion."

These reference amounts, which are part of the regulations, are broken down into 139 FDA-regulated food product categories, including 11 groups of foods specially formulated or processed for infants or children under 4. They list the amounts of food customarily consumed per eating occasion for each category, based primarily on national food consumption surveys.

Grams (g) and milliliters (mL) are the metric units that are used in serving size statements.

Free: This term means that a product contains no amount of, or only trivial or "physiologically inconsequential" amounts of, one or more of these components: fat, saturated fat, cholesterol, sodium, sugars, and calories. For example, "calorie-free" means fewer than 5 calories per serving, and "sugar-free" and "fat-free" both mean less than 0.5 g per serving. Synonyms for "free" include "without," "no" and "zero." A synonym for fat-free milk is "skim".

Zero Trans Fat: One of the rules that went into effect on January 1, 2006 was that the amount of trans fat in a food product must be listed on the nutrition label. Thus, consumers will be seeing "zero trans fat" on more products.  Manufacturers are allowed to use this statement if the product contains less than 0.5 gram per serving.  However, consider the Tour de France cyclist who, during a single day of racing, may consume 8-10 energy bars that contain 0.4 grams of trans fat per bar.  In this scenario, the cyclist would be consuming a fairly substantial amount of an undesirable food additive, despite the label indicating "zero trans fat."

Low: This term can be used on foods that can be eaten frequently without exceeding dietary guidelines for these components: fat, saturated fat, cholesterol, sodium, and calories. Thus, descriptors are defined as follows:

• low-calorie: 40 calories or less per serving
• low-cholesterol: 20 mg of cholesterol or less per serving combined with 2 g or less of saturated fat per serving
• low-fat: 3 g or less per serving
• low-saturated fat: 1 g or less per serving
• low-sodium: 140 mg or less per serving
• very low sodium: 35 mg or less per serving

Synonyms for low include "little," "few," "low source of," and "contains a small amount of."

High: This term can be used if the food contains 20% or more of the Daily Value for a particular nutrient in a serving.

Good source: This term means that one serving of the food contains 10 to 19% of the Daily Value for a particular nutrient.

Reduced: This term means that a nutritionally-altered product contains at least 25% less of a nutrient or calories than the regular, or reference, product. However, a product can't claim to be "reduced" if its reference food already meets the requirement for a "low" claim.

Less: This term means that a food, whether altered or not, contains 25% less of a nutrient or calories than the reference food. For example, pretzels that have 25% less fat than potato chips could carry a "less" claim. "Fewer" is an acceptable synonym.

Light: This descriptor can mean two things:

• First, that a nutritionally altered product contains one-third fewer calories or half the fat of the reference food. If the food derives 50% or more of its calories from fat, the reduction must be 50% of the fat.

• Second, that the sodium content of a low-calorie, low-fat food has been reduced by 50%. In addition, "light in sodium" may be used on food in which the sodium content has been reduced by at least 50%.

The term "light" still can be used to describe such properties as texture and color, as long as the label explains the intent -- for example, "light brown sugar" or "light and fluffy."

More: This term means that a serving of food, whether altered or not, contains a nutrient that is at least 10% of the Daily Value more than the reference food. The 10% of Daily Value also applies to "fortified", "enriched", "added", "extra", and "plus" claims, but in those cases, the food must be altered.

Healthy: A "healthy" food must be low in fat and saturated fat and contain limited amounts of cholesterol and sodium. In addition, if it's a single-item food, it must provide at least 10% of one or more of vitamins A or C, iron, calcium, protein, or fiber. The sodium content cannot exceed 360 mg per serving for individual foods and 480 mg per serving for meal-type products. Exempt from this "10-percent" rule are certain raw, canned and frozen fruits and vegetables and certain cereal-grain products. These foods can be labeled "healthy," if they do not contain ingredients that change the nutritional profile, and, in the case of enriched grain products, conform to standards of identity, which call for certain required ingredients.

HEALTH CLAIMS

Claims for 10 relationships between a nutrient or a food and the risk of a disease or health-related condition are now allowed on food labels. They can be made in several ways: through third-party references (eg., the National Cancer Institute), statements, symbols (such as a heart), and vignettes or descriptions. Whatever the case, the claim must meet the requirements for authorized health claims. For example, they cannot state the degree of risk reduction and can only use "may" or "might" in discussing the nutrient or food-disease relationship. And they must state that other factors play a role in that disease.

The claims also must be phrased so that consumers can understand the relationship between the nutrient and the disease and the nutrient's importance in relationship to a daily diet. An example of an appropriate claim is: "While many factors affect heart disease, diets low in saturated fat and cholesterol may reduce the risk of this disease."

The 10 allowed nutrient-disease relationship claims and rules for their use can be found at: www.fda.gov.

ROOM FOR IMPROVEMENT

Today's food label offers more complete, useful and accurate nutrition information than ever before. Still, they could be better:

• Improve the layout so that it is easier to read and more logical to understand. For example, group the 3 main macronutrients (carbs, fats, protein) together so that it is easier to add up total calories and determine the ratios of these 3. Also, list all the vitamins together, and list all the minerals together. Within each of these lists, alphabetize the ingredients.

• Carbohydrates: Provide a "calories from carbohydrates" value, just as there is for "fats". Also, since high-glycemic index foods have been linked to obesity, require manufacturers to list the glycemic index value of their products when it is known.

• Fructose: Because fructose is believed to pose health risks (Havel PJ. 2005), require manufacturers to list the actual amount (in milligrams or grams) of this sweetener in their products. (see our review:  "Fructose: Public Enemy #1?")

• Serving size: Certain rules apply to food products that are packaged and sold individually. If such an individual package is less than 200% of the applicable reference amount, the item qualifies as one serving. Thus, a 360-mL (12-fluid-ounce) can of soda is one serving, since the reference amount for carbonated beverages is 240 mL (8 ounces).

However, if the product has a reference amount of 100 g or 100 mL or more, and the package contains more than 150% but less than 200% of the reference amount, manufacturers have the option of deciding whether the product can be one or two servings.

An example is canned soup: The serving size reference amount for soup is 245 g. For a 420 g (15-ounce) can of soup, the manufacturer has the option to declare the can of soup as one or two servings.

Obviously, this is very confusing to the consumer. So, one of the next changes likely to be seen on food labels is "number of servings per package".

QUESTIONS

Q: Are "fractionated" oils the same thing as "partially-hydrogenated" oils?

ANSWER: No. Fractionated oils are not "partially-hydrogenated". But, even though they don't contain trans fats, they do contain saturated fat, which should also be limited. The USDA recommends that the combined intake of trans fats and saturated fats be no more than 20 grams per day.

SUMMARY

Food labels have been revised several times since their debut in the early 1970s.  They now provide some very useful information for consumers.

However, consumers need to be careful.  Amounts are listed "per serving."  But the typical amount they consume may be larger than that.  An example might be a cereal serving size of "one-half cup" or "2 cookies"....most people consume more than that in one serving.

Also, some "rounding off" of values is allowed.  For example, total calories are reported to the nearest 10 (ie., 134 calories might be reported as 130) and "zero trans fat" could mean any amount between zero and 0.4 g per serving.

Currently, it is not possible to calculate the amount of fructose in a product from the information provided on the Nutrition Facts panel.  Thus, while food labels are helpful, there is still room for improvement.

FOR MORE INFORMATION

The information above was obtained from the government document "BG 99-5", dated May 1999 (replaces BG 95-14). For more information, contact the FDA:

• General Inquiries: 1-888-INFO-FDA (1-888-463-6332)
• Food Safety Hotline: 1-800-332-4010
• The FDA's Center for Food Safety and Applied Nutrition (CFSAN) web site provides a lot of information regarding food labels: www.cfsan.fda.gov/label.html.

Although it is intended to be an academic text, "Perspectives In Nutrition" (by Wardlaw, Hampl, and DiSilvestro) is a nutrition book that most consumers could use.  The information is written in easy to understand language, and, the multitude of colorful diagrams, tables, and pictures help to explain the concepts.  While it may be more information than you need (the Appendix alone is 203 pages!), it truly is an outstanding resource. Read our review.

Readers may be interested in the following related stories:

• Energy Bars
• Energy Drinks
• Energy Gels, etc.
  
• Fructose: Public Enemy #1?
  
• Sports Drinks and Recovery Drinks

PERSONALIZED FITNESS and WELLNESS COUNSELING

If you'd like some help designing your personal fitness program, or have questions regarding exercise, or simply want some regular motivation, sign-up for our Fitness Counseling Service. It may be the best investment in your health that you'll ever make.

REFERENCES

Code of Federal Regulations Title 21: Food and Drugs: "Part 101: Food Labeling"

FDA Consumer Web Site: "How to Understand and Use the Nutrition Facts Label"

Havel PJ. Dietary fructose: implications for dysregulation of energy homeostasis and lipid/carbohydrate metabolism. Nutr Rev 2005;63:133-157.  Abstract

Men's Health, October 2004, p. 144.

ABOUT THE AUTHOR

Stan Reents, PharmD, is a former healthcare professional. He holds Personal Trainer and Lifestyle Counselor certifications from the American Council on Exercise and has been certified as a tennis coach by USTA. He is the author of Sport and Exercise Pharmacology (published by Human Kinetics).  He can be reached at: Editor@athleteinme.com.