The newly released Dietary Guidelines for Americans, 2005 provides the latest scientific consensus about the role that diet plays in living a healthful lifestyle. It also points to the importance of providing consumers with the necessary tools so that they can be successful in meeting that goal. The role of nutrition communicators, dietitians, and other health professionals in helping Americans learn how to implement the new Dietary Guidelines cannot be overemphasized. Various educational tools exist, and as the new Dietary Guidelines points out, “the food label and the Nutrition Facts panel provide information that is useful for implementing the key recommendations in the Dietary Guidelines and should be integrated into educational and communication messages.”

Consumers indicate that they are looking at labels to make food choices. According to the 2004 Food Marketing Institute (FMI)/Prevention Magazine: Shopping for Health consumer trends survey, shoppers are buying products that claim to reduce the risk of disease. Forty-two percent of respondents said that they have purchased foods claiming to reduce their risk of developing heart disease, and 26 percent said that they had purchased foods claiming to reduce the risk of cancer. We also know that consumers are interested in seeking out foods on the basis of the health-related benefits that they provide. In fact, consumers state that they want to learn more about such foods.

Today, the food label offers more complete, useful, and accurate information than ever before. Fifteen years have passed since the enactment of the Nutrition Labeling and Education Act (NLEA)—and as the scientific community continues to learn more about the emerging research on diet and health—more and more foods bear nutrition-related claims to inform consumers of the special nutritional properties that certain foods and dietary supplements may deliver. NLEA was designed to give consumers scientifically valid information about the foods that they eat, including the use of “truthful, non-misleading, and useful” label statements that describe the relationship between a food and health-related conditions. With oversight from the US Food and Drug Administration (FDA) and the US Department of Agriculture (USDA), food labels provide a wealth of information that consumers can use. In fact, FDA has been increasing its efforts to expand opportunities for food manufacturers to provide meaningful, up-to-date information to consumers about the health effects of their dietary choices, through additional health claims based on emerging science (“qualified” health claims).

With more emphasis on the recommendation/advice to “get the most nutrition out of our calories” in the words of the recently released Dietary Guidelines for Americans, 2005, there is an even greater need for consumers to understand how to put this information into practice. The Nutrition Facts Panel and label claims on the food package can be used to identify the amount of key nutrients a serving provides to help ensure consumption of essential nutrients for good health. Rather than using the food label to determine only those nutrients that should potentially be decreased in the diet, consumers can also use the food label to learn which foods provide important nutrients that should be increased in the diet. Further, nutrition-related claims also provide consumers with the opportunity to learn about the positive health benefits of various nutrients and food components not included on the Nutrition Facts panel.

What’s in a Claim? Making Sense of Nutrition-Related Claims

Claims on food labels are made to identify the nutrition-related attribute of a food. Regulated claims that can be used on food and dietary supplement labels fall into the following categories: (1) health claims, (2) nutrient content claims, (3) structure-function claims, and (4) dietary guidance statements. For the first two, health and nutrient content claims, a food must meet criteria pre-approved by the FDA.

1) Health claims confirm a relationship between a food or a component in a food—such as calcium, fat, soluble fiber, soy protein, or plant sterols—and risk of a health-related condition or disease, like heart disease or cancer. Health claims can be authorized in three ways:

• NLEA-Authorized Health Claims. These claims are based on a rigorous review of scientific literature, using a significant scientific agreement (SSA) standard. They are sometimes called unqualified health claims because they meet the SSA standard and do not require a qualifying statement to explain the state of the science (see Qualified Health Claims below). “Diets low in saturated fat and cholesterol that include 25 grams of soy protein a day may reduce the risk of heart disease. One serving of [name of food] provides X grams of soy protein” is an example of an unqualified health claim.
• Authoritative Statements Based on the Food and Drug Administration Modernization Act of 1997 (FDAMA). This Act allows a health claim to be used on the basis of an authoritative statement by a scientific body of the US government or the National Academy of Sciences. They still must be approved by FDA. An example of a FDAMA-authorized health claim is “Diets containing foods that are a good source of potassium and that are low in sodium may reduce the risk of high blood pressure and stroke.”
• Qualified Health Claims. The launch in March 2003 of FDA’s Consumer Health Information for Better Nutrition Initiative provided for the use of qualified health claims to communicate emerging evidence for a relationship between a food, food component, or a dietary supplement and the reduced risk of a disease or health-related condition. Therefore, qualified health claims convey a developing relationship between components in the diet and risk of disease on the basis of the weight of the credible scientific evidence available. “Qualifying” language is included as part of the claim to indicate that the evidence supporting the claim has not yet reached the standard of SSA. An example of a qualified health claim is, “Scientific evidence suggests but does not prove that eating 1.5 ounces per day of most nuts [such as name of specific nut] as part of a diet low in saturated fat and cholesterol may reduce the risk of heart disease."

2) Nutrient content claims on a food label characterize the level of a nutrient in a serving of the food. This type of claim is authorized under NLEA. To make this type of claim, a food product must contain a FDA-designated amount of the nutrient per reference amount (or standard serving size). Example phrases used for nutrient content claims include excellent source of [nutrient], good source of [nutrient], fat-free, rich in [nutrient], low cholesterol, reduced saturated fat, less sugar, more fiber, light, and many more.

3) Structure-function claims describe the role of a nutrient or dietary ingredient that affects or maintains the normal structure or function of the body. For example, “calcium builds strong bones,” “fiber maintains bowel regularity,” or “lycopene maintains cell integrity.”

4) Dietary Guidance Statements are statements on a label that describe the health effects of a broad category of foods. FDA, as part of a cooperative effort with the National Cancer Institute (NCI), offers this dietary guidance message for consumers: “Diets rich in fruits and vegetables may reduce the risk of some types of cancer and other chronic diseases.”

Consumers can use nutrition labels to make informed food choices for improved health. However, the food label is only one way to guide consumers to make healthful dietary choices; the food label is a tool and does not, in and of itself, provide education to consumers. Research shows time and again that consumers continue to be confused by nutrition information; they often state that they hear conflicting advice from a variety of sources—family, friends, professional colleagues, journalists, and the Internet, among others. This can result in information overload. Thus, the context that can help put the information into perspective and therefore, practice, is often lacking.

Consumer-based communications and education are essential to the success and effectiveness of any dietary guidance or food labeling system. Additional consumer research is needed to better understand how and to what extent labeling information is used and understood by consumers. This will ensure that the information effectively promotes consumer awareness and is helpful in making purchase decisions, allowing consumers the opportunity to better implement the Dietary Guidelines for Americans, 2005. In the meantime, health professionals, in coordination with other health communicators such as the government, media, and industry, have the opportunity to provide the context that consumers need to interpret labels so that they can translate the information into a set of actionable choices that will lead to achieving the goal of an overall healthful diet and lifestyle.

For more information:

Dietary Guidelines for Americans, 2005. Dietary Guidelines for Americans, 2005. U.S. Department of Health and Human Services and U.S. Department of Agriculture. HHS publication number: HHS-ODPHP-2005_01_DGA-A; USDA publication number: Home and Garden Bulletin No. 232. www.healthierus.gov/dietaryguidelines

Resources on How to Use the Food Label (including a list of currently authorized label claims)
US Food and Drug Administration Center for Food Safety and Applied Nutrition. Food Labeling and Nutrition, http://www.cfsan.fda.gov/label.html