Monday, June 6, 2016

Revised Food and Nutrition Facts Label--A Step Forward...more to go

As the obesity epidemic continues unabated in the United States, costing more than $190 billion per year in health care expenditures,1 a public health crisis is unfolding that warrants careful reevaluation of existing policies to combat obesity and related chronic diseases. Recently, the US Food and Drug Administration (FDA) announced the first major amendment of the Nutrition Facts Label in more than 2 decades, to be implemented in the next 2 to 3 years, to reflect the evolving evidence related to dietary factors and risk of chronic diseases. The collective changes update the list of nutrients that are required or permitted to be declared, provide reference Daily Values based on current dietary recommendations or consensus reports, adjust serving sizes and labeling requirements for certain package sizes, and revise the overall format and appearance of the label for enhanced interpretability.2

The label provides point-of-purchase nutrition information in a standardized format to help guide consumers’ food and beverage choices. All packaged food items regulated by the FDA—everything from breads and cereals to canned and frozen foods, snacks, desserts, and beverages—are required to display information on the label pertaining to serving size, number of servings, total energy, and a selection of nutrients based on their role in chronic disease etiology or nutrient deficiency: energy from fat, total fat, saturated fat, cholesterol, sodium, carbohydrates, dietary fiber, sugar, protein, vitamin A, vitamin C, calcium, iron, and, most recently, transfat. With more than 61% of US adults reporting that they use the Nutrition Facts panel when deciding to purchase food, these labels have great visibility and potential to be important tools for public education and policy.3

Many people are already familiar with this label, and it is taught in some schools. It is fairly straight forward, however many people who need to know this the most seem to be unaware of what it contains, and how it simplifies what you should buy and eat.  It is not complicated.

Perhaps the most important part of the label is the Calories in each serving. Taking all other things in to consideration generally less is good. However what is in those calories is of major importance. Think of calories as energy, or gasoline in your car's fuel tanks. Calories can also be  equated with 'heat'. Your body produces heat by burning calories,  for breathing, basal metabolism, physical activity, and brain  power.  Your brain consumers about 25% of your caloric supply. 

Think of your fuel tank as containing 'good fuel and bad fuel'  Good fuel is burned efficiently and does not create toxic emissions when burned.  Bad fuel is not used efficiently and produces toxic byproducts which may be harmful to your brain and other cells.  

Look at the total number of fat calories in each serving. The total number of calories of fat should be less than 30% in  your daily diet. Be careful not to confused this with the % age of daily calories of fat in each serving.

Be that as it may some people just don't read or pay attention to the guidelines.  Would you put leaded gas in your tank? At one time many cars could burn leaded gas which raised the octane (power rating) of gas.  Today all cars have catalytic converters, and there is no leaded gas in the United States. (leaded gas destroys catalytic converters which contain platinum. 

And like the fuel industry, government is now regulating some foodstuffs, especially those containing large amounts of added sugar (soda).  The new labeling requirement for added sugar is timely and accompanies other policy initiatives aiming to reduce intake of sugar-sweetened beverages and added sugars. For example, in 2015 Berkeley, California, implemented an excise tax of 1¢ per ounce on sugar-sweetened beverages, and San Francisco, California, recently passed a ruling to issue health warning labels on sugar-sweetened beverages. Boston, Massachusetts, has prohibited the sale of sugar-sweetened beverages on city property, and many school districts have banned sales and vending of these beverages as strategies to help curb childhood obesity. Similar to the case of trans fat, these collective legislative actions to reduce added sugar intake can create an environment that fosters and supports behavioral change toward more healthful choices and are more 

Another factor is the amount of trans-fats (bad), the amendment to the original label was the addition of a required line for trans fat content, implemented in 2006 in response to substantial evidence linking intake of trans fat to adverse cardiometabolic health. This provided a strong incentive for manufacturers to eliminate trans fat; together with city- and state-level regulatory action limiting trans fat use in restaurants it has been largely eliminated from the US food supply. The FDA recently announced removing trans fat from the “generally regarded as safe” category, setting a 2018 deadline for the US food industry to eliminate it from all products. The substantial reduction in trans fat intake, from 4.6 to 1.3 g/d,4 accounted for about half of the improvement in US diet quality since 2000 and is likely a major factor contributing to improvements in blood lipid levels5 and a decline in type 2 diabetes in the United States.6


The new changes will further align the label with current dietary guidelines.7 One important change is the addition of a line disclosing “added sugar” content. The Daily Value (% DV) for added sugar is 10% of calories, representing a limit of 50 g (roughly 12 teaspoons) of added sugar for a 2000-calorie diet, a typical daily intake for adults (Figure). Although intake of added sugar has decreased in recent years in the United States, consumption still exceeds recommendations, with the average adult consuming 22 teaspoons of added sugar per day. Sugar-sweetened beverages alone account for 39% of all added sugar intake.7 Intake of sugar-sweetened beverages and added sugar is associated with weight gain and increased risk of type 2 diabetes and cardiovascular disease.8 Based on these data, the 2015-2020 Dietary Guidelines for Americans recommend limiting added sugar intake to less than 10% of daily calories.7 Once the changes are implemented, the label on a 20-oz (591 mL) bottle of soda, for example, would indicate that individuals are consuming 130% of their added sugar limit for the day (for a 2000-calorie diet).

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