Two of the most respected and independent experts on nutrition have published an editorial article in the Journal of the American Medical Association (JAMA) calling for the ban of front of package nutrition labels and health claims. The paper, entitled Front-of-Package Food Labels Public Health or Propaganda? [download PDF] is coauthored by Marion Nestle, a professor at NYU, and professor David Ludwig of Harvard University’s School of Public Health.

In the editorial, the authors review the history of health claims, the relationship between the food industry, Congress, and the FDA, and the big mess we are in today. They provide five reasons why front-of-pack labeling, instead of providing a useful service to consumers, has actually done the opposite:

1. Health claims cannot be easily verified. But people perceive them as absolute truths approved by governmental health bodies.

2. Claims about specific positive nutritional benefits are misleading. Cereals “fortified with vitamins and minerals” but full of sugar come to mind as one example.

3. Singling out a specific nutrient is misleading. A can of Coke has less fat than a handful of nuts. Which is better?

4. “Healthier” is not necessarily healthy. So a junk food with “Now 20% less sugar” is still junk food.

5. Inherent conflict of interest between wanting to sell more products and wanting to educate the public.

The authors add that only strict regulation, based on scientific standards, can assure trustworthy labeling. But because the standards are easily manipulated and in many cases the science is inconclusive, the best solution is to just kill off the front of pack labeling. They admit that this may pose 1st Amendment challenges, and suggest that the FDA and Congress deal with the issue through legal remedies.

In the meantime, improvements in the existing nutrition facts panel can help consumers make smarter choices. We agree, and have a laundry list of suggestions.

What to do at the supermarket:

It’s usually the “silent” products that are healthier for you – the fresh fruit and vegetables that don’t have nutrition information, and the bulk items like nuts and seeds, etc…They don’t have sexy packaging or big marketing budgets.

As a rule, when buying packaged foods, ignore the health claims and go directly to the ingredient list and nutrition fact panel. True, it’s harder to read, requires some learning to master, and is more time consuming. But it will give you a fuller picture of the product, not just what the manufacturer wants you to know.

And if you have any questions, Fooducate is here for you.

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The Heart Check Symbol – one of the first front-of-pack nutrition labels – was created by the American Heart Association in 1995. The idea was to give people a quick visual cue as to foods that were low in saturated fat and cholesterol. Unfortunately, the sugar count was not considered. And thus, ridiculously sweet and unhealthy foods started to appear with the heart check symbol.

No more, says an AHA spokesperson:

The association advocates limiting the amount of discretionary calories in the diet which come from added sugars. Since desserts are a significant source of added sugars, we have elected to close the dessert category to further certification.”

What you need to know:

This is a good development.

Endorsements on food products by respected health organizations are a double edged sword. On one hand, the AHA wanted to promote healthier eating habits. But on the other hand it began to develop a tidy little revenue stream, charging companies thousands of dollars per product endorsement.

That creates an unnecessary tension that could potentially cause the criteria for heart healthy food to be lower than if no money was being paid. Not saying that this is what happens, but it could.

In general, nutrition labeling that is not regulated by the FDA is an opening for various tricks, shenanigans, and nutrition voodoo. Instead of contributing to healthier consumer choices, such labels may actually achieve the opposite.

What to do at the supermarket:

Your best bet is NOT to rely on front-of-pack labels or other health claims, and head straight to the ingredient list and nutrition facts panel. Granted, it’s more time consuming and requires effort, but if you need help – we’re here to provide advice.

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Just when we thought we had covered all the nutrition rating systems out there, here’s a new system being implemented at Whole Foods Market stores nationwide. ANDI, short for Aggregate Nutrient Density Index, is the brainchild of author, MD, and founder of Eat Right America, Dr. Joel Fuhrman.

The ANDI system is a part of a bigger initiative by Whole Foods, entitled Health Starts Here, which encompasses not just making healthy food available, but also providing education on what to do what with that food (culinary lessons, 28 day programs to jump start healthy eating habits…).

The healthy eating principles WFM is promoting are:

• plant based diet
• whole foods (less processed flours, for example)
• low fat – or the right fats (unsaturated, more from plants and less from animals)
• nutrient dense (that’s where ANDI comes in)

The ANDI score, based on a Dr. Fuhrman’s Nutrient Density Scoring System analyzes many nutrients in a food product

Calcium, Carotenoids: Beta Carotene, Alpha Carotene, Lutein & Zeaxanthin, Lycopene, Fiber, Folate, Glucosinolates, Iron, Magnesium, Niacin, Selenium, Vitamin B1 (Thiamin) Vitamin B2 (Riboflavin), Vitamin B6, Vitamin B12, Vitamin C, Vitamin E, Zinc, plus ORAC score X 2 (Oxygen Radical Absorbance Capacity is a method of measuring the antioxidant or radical scavenging capacity of foods).

The data for whole foods such as produce, grains, and legumes is relatively easy to analyze based on USDA databases. It is much more complicated to get accurate info for packaged or processed foods, especially because the ingredients in a processed food interact with each other and change the nutrition profile of a product.

Here is a table with some sample scores. The highest score is 1000, the lowest is close to zero.

This is a very interesting table, especially if one compares it to NuVal ranking which goes from 1-100. Take a look at these 4 healthy products and their scores:

• Kale – 1000
• Orange – 109
• Whole wheat bread – 25
• Olive oil – 9

A naive shopper may be led to believe that kale is the only product worth consuming. But all 4 of the aforementioned are healthy and needed by our bodies. Dr. Fuhrman addresses this:

Keep in mind that nutrient density scoring is not the only factor that determines good health. For example, if we only ate foods with a high nutrient density score our diet would be too low in fat. So we have to pick some foods with lower nutrient density scores (but preferably the ones with the healthier fats) to include in our high nutrient diet.

So wouldn’t it be more practical to create a scoring system that doesn’t require people to analyze a score , the product type, the required nutrients and then decide? The entire point is to simplify life for consumers, not complicate it!

Whole Foods is perceived as a healthier, albeit expensive, grocery retailer. But recently John Mackey, WFM CEO and founder, openly admitted that his chain sells lots of junk food. The Health Starts Here program may be a signal that Mackey is retuning to the roots of what WFM stood for in the seventies when just starting out.

The ANDI scores are an interesting first step in trying to help consumers better choose healthier foods, and it will be very interesting to see consumer response. We expect Whole Foods will continue to introduce and test additional tools to help their customers.

What to do at the supermarket:

Don’t let the Whole Foods health halo confuse you, as organic junk food is still junk food. Stick to the less processed products, of which Whole Foods has copious amounts, including in bulk (cheaper).

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We just got off the phone with Tom Vilsack!

The Fooducate blog was honored to be invited to a first ever blogger conference call with U.S. Department of Agriculture secretary Tom Vilsack earlier today. The call was in celebration of the USDA joining as a partner in the  “Fuel Up to Play 60” partnership between the National Dairy Council and the NFL.

The idea of the program is to educate and empower kids to make healthier food choices as well as exercise 60 minutes a day. Over 60,000 schools have signed up to the program so far.

This is a win-win for everyone involved. The star power of the NFL athletes is a huge magnet for kids who move their bodies more. And obviously the dairy council is happy because low-fat milk is getting pushed to the schools instead of other, less nutritious beverages.

And while we commend this shift from soda pop to milk, we take point at the “flavored milk” options that are sneaking in tons of sugar to kids through the back door. The most popular flavored milk is, of course, chocolate milk. It’s also a drink that Mr. Vilsack admitted that he loves, deferring a question about the sweetness by blogger Eddie Gehman Kohan of ObamaFoodorama.

Unfortunately, an 8 oz. single serve bottle of chocolate milk has THREE TEASPOONS of added sugar. While consuming this once a day will not have a huge caloric impact (3 teaspoons = 12 grams = 48 added calories), the uber-sweetness has an unwanted side effect – suddenly apples, pears, bananas, and even the chocolate milk prepared at home (milk+cocoa powder) don’t see so tasty anymore. They’re not sweet enough.

In the Q&A part of the call, I asked Secretary Vilsack why not work with the Dairy Council to move the manufacturers to lower sugar levels. The response from Jean Ragalie, the Executive Vice President of Health and Wellness at NDC, was :

1. the sugar in chocolate milk is only 2% of added sugars consumed by kids, so it is insignificant. (Update – here is the exact data: Flavored milk accounts for less than 3.5 percent of added sugar intake in children ages 6-12 and less than 2 percent in teens. To put this in context, soft drinks, fruit drinks and tea provide a combined 31.5 percent of total added sugar intake for children ages 6-12 and 40 percent for teens according to NPD Nutrient Intake Database (2 years ending Feb, 2009))
2. studies show that children drinking chocolate milk are not gaining any more weight than others, but are getting more milk in their bodies, which is important due to milk’s inherent nutrition.
3. Lastly and most disturbing, Secretary Vilsack summed in a nutshell: Kids won’t drink chocolate milk unless it’s this sweet.

It’s a vicious cycle. The kids get hooked on super sweet tastes starting with their morning cereal, then their candy bars during recess, followed by chocolate milk that must be as sweet. And more sweet as the day winds down at home.

No wonder the fruit served at lunch alongside the chocolate milk tastes so bland.

We suggested in the past, and still do – NDC, USDA – please work together to “convince” manufacturers to reduce the sugar in their flavored milks. Build a voluntary incentive plan to have manufacturers remove half a teaspoon of sugar  every school year for the next 3 years, and we promise to shut up about this matter.

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First Lady Michelle Obama has a legacy she wants to leave behind: drastically reducing childhood obesity. Yesterday at a Mayors Conference in Washington DC,  she announced a new initiative in this spirit, to be formally announced in February.

After presenting the dismal stats (around 18% of kids are obese), Mrs. Obama outlined what is to be a joint effort at the federal, municipal, and non-profit levels.

“The idea here is very simple: to put in place commonsense, innovative solutions that empower families and communities to make healthy decisions for their kids.”

The main points:

• improved school lunches
• more physical activity (including school phys-ed cut due to budget constraints)
• access to fresh and healthy foods in all communities (nutrition deserts are all too common in poor urban areas)
• nutrition education for kids and their parents.

This is a great plan, and Mrs Obama deserves kudos for bringing childhood obesity to our collective attention. No doubt her status as the nation’s number one mom, with personal experiences and challenges in feeding her family, make her one of the best champions for the cause.

However…

I’m sorry, First Lady, your plan, while commendable, doesn’t have a fighting chance.

Here’s why: Read more…

Cereal has become, in just over a century, the quintessential American breakfast. Tens of millions of people start their day with a bowl of flakes, puffs, or crisps poured from a cardboard box .

There are over 1000 different cold cereal products one can choose from, and any given supermarket dedicates an entire aisle to these. Last year, Americans bought over Ten Billion dollars worth of breakfast cereal. This is a big business, with lots at stake for manufacturers, big and small, who fight for every sliver of market share.

Let’s remind ourselves that cereal is not the only option for breakfast. Whole wheat toast, banana, yogurt, cheese, fruit salad, a glass of milk, and eggs are a great start to a day, and don’t require much effort.  For many households, though, cereal is a morning tradition not easily broken. But can it be nutritionally improved?

As consumers are becoming more educated about health and nutrition, the cereal category is in flux, with each brand trying to convince us that its line of products is the nutritional Olympus. Despite small improvements here and there, most of the achievements are in marketing claims. Shoppers are now more confused than ever – with an overload of conflicting information – and no true means to decipher it all to make a good decision.

No more.

Today, we are happy to announce CerealScan™, an iPhone application that will help you choose a better, more nutritious breakfast cereal at the supermarket.

It’s dead simple to use: You launch the CerealScan application on your iPhone. It automatically scans a cereal box’s barcode (UPC).   You then see a product dashboard with concise, graphic information that helps you decide in 3 seconds if the cereal is healthy enough for you. If not, CerealScan shows 5 better choices.

Here is an example (see image). The scanned cereal scores only 2 out of 5. It is high in sugar and medium in sodium. It contains trans fats and controversial artificial colorings. Not good. Swipe your finger across the alternatives to view all 5 better options. Tap on an alternative’s image to see its nutrition dashboard.

How it works: We’ve culled over 2000 cereal boxes into the CerealScan database. The analysis and recommendations are fully automated. They are modeled on answering a simple question – “What would a dietitian recommend if she was standing there with you at the cereal aisle?” The implementation of that answer is by no means trivial. Thankfully a dedicated group of dietitians and programmers at Fooducate have been working on this project for quite some time. I think they’ve done a great job.

If you want to to learn more, there’s more information at the Cereal Scan Website. To get it on Apple’s iTunes click here.

What to do at the supermarket:

When it comes to cereal, the basics we’ve been writing about for the past 18 months have not changed. More fiber, Less sugar. No artificial colors and funny preservatives.

Now you have another option – you don’t need to remember anything, just bring your iPhone along with you to the supermarket and use CerealScan.

Try it out, we’d love to hear how CerealScan has helped you make a better choice. Comment below or email us: cerealscan at fooducate dot com.

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Should we be adding nutrition to New York’s list of leadership roles in addition to finance, tourism, and entertainment?

After paving the path with calorie labeling in fast food restaurants, banning trans-fat, shocking us with anti-soda pop ads, and then suggesting a tax on sugary drinks, the city’s department of health circa January 2010 is all about salt reduction.

In a press release yesterday, the health department announced a plan for voluntary reduction of salt from packaged foods and in restaurants of 25% over the next 5 years. The National Salt Reduction Initiative, is a New York City-led partnership of cities, states and national health organizations, that plans to work with the industry to achieve this goal. Precedents exist on national levels, most notably in Finland, which nearly halved sodium consumption over several decades starting in the 1970’s.

What you need to know:

A bit of salt is good, both for our body and our food enjoyment. The problem for many Americans is that the bit-of-salt has become too-much-salt, almost twice as much as we need to consume. And the excess is not doing us any good:

• Diets high in salt increase blood pressure, a leading risk factor for heart attacks and stroke.
• These conditions cause 23,000 deaths in New York City alone each year – more than 800,000 nationwide – and cost Americans billions in healthcare expenses
• Most Americans eat almost twice the recommended limit of salt each day.
• Even people with normal blood pressure benefit from lowering their salt intake.

Over 70% of the salt we consume comes from processed foods, whose manufacturers have been under a certain pressure to reduce their salt content for several years. Their big problem is who’ll jump into the cold water first. You see, our collective taste buds are currently wired to extra-salty. If one manufacturer decides to dramatically decrease the salt value in its foods while the others don’t , it stands a chance of falling out of f(l)avor with consumers and losing market share.

That’s why a coordinated effort where all manufacturers are required to reduce sodium gradually over time may be a good idea.

Incidentally, in the food industry’s praise (which is not something Fooducate often doles out) some manufacturers have been reducing sodium content gradually and quietly over the last few years. It’s interesting to note the stark difference in approach in canned soup, a notoriously sodium laden product, between Campbell’s and Progresso. Both are reducing their salt content but while the former proudly boasts the sodium reduction on its products and marketing materials, the latter is keeping mum.

What to do at the supermarket:

While we wait for salt values to enter orbit, let’s not fool ourselves into complacency. Salt is still a big issue and even after the proposed reduction values will be higher than necessary. The fastest way to lose the salt is to eat less processed foods. If you do buy prepared foods, look at the sodium values and compare.

A good number to remember is 600mg per serving. Lower is better, higher is not.

PS – enjoy the video of Alicia Keys singing about NY. Not directly related to nutrition or nutrition, but probably one of the best thing in music in a long while…

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A great article called The Vita Myth appeared earlier this week in online magazine Slate. Science writer Emily Anthes tears apart the $25B-a-year-and-growing supplement industry.

Half of Americans pop a multivitamin or other supplement regularly. But substantial studies in the past few years have shown that for the most part, these supplements did not provide any health benefits, aside from those of the supplement companies:

1. A study of more than 160,000 post-menopausal women, published in the Archives of Internal Medicine, found that multi-vitamins supplements did not prevent cancer, heart attacks, or strokes and did not reduce overall mortality. [see here]

2. A 2006 National Institutes of Health panel of experts evaluated evidence that vitamin pills could prevent chronic disease. The scientists that there is no “strong evidence for beneficial health-related effects of supplements taken singly, in pairs, or in combinations.”

3. Antioxidant supplements (vitamins A, C, and E, selenium, beta carotene, and folate) fail to protect against heart disease, stroke, and cancer. But, get this, they actually increase the risk of death, according to a 2007 analysis of research on more than 232,000 people, published in the Journal of the American Medical Association (JAMA).

Wow – this boggles the mind.

What you need to know:

The American Dietetic Association just recently reminded us that people should get their nutrients from real food, not supplements. The science of nutrition is relatively young, and for every known nutrient, there are hundreds that scientists have yet to figure out. Interactions between various nutrients in a certain vegetable or fruit contribute differently to your health than if you just take a pill with one or two vitamins.

Some people argue that we must take a daily multi-vitamin because the produce in this nation has been depleted of it nutritional value over the past few decades. This, due to the depletion of nutrient from soil as a result of industrialized agriculture, pesticide use, and monocultures.

Hogwash, according to Joanne Larsen, RD, of Ask the Dietitian: There is no proof that soil is losing its mineral content.  Minerals in soil are pretty stable and don’t migrate unless there is erosion or flooding that washes minerals away.  Soils are replenished with fertilizers (organic or chemical) periodically.

Individual vitamins are created by fruits and vegetables through the oxidative process determined by each plant’s genetics.  Some plants are naturally high in particular nutrients than others. We are not seeing mutations in plant genetics that affect vitamin content. If soils were becoming depleted of nutrients, we would see widespread nutrient deficiencies in the American population.  We are not.

So if real food has all the vitamins and minerals we need, and supplements could actually be detrimental, how is it that we are paying  twenty five billion dollars a year for what amounts to smoke and mirrors?

Note: There are people that require specific boosts in certain nutrients. We’re not referring to those needs here.

What to do at the supermarket:

If you are a healthy person, get your nutrition from real food. Plenty of vegetables, fruits, whole grains, legumes, dairy and meat. The less processed the better. You never know what “benefits” the presence of industrial additives and artificial chemicals will amount to once inside your body.

And foods that are fortified with lots of vitamins and minerals, for example breakfast cereals? A secondary consideration compared to the importance of whole grains and low sugar content.

Says Emily Anthes – we should stop treating supplements like health candy and more like prescription meds, to be used only when there’s a demonstrated need.

(hat tip to Dan Mitchell of The Daily Bread for the story)

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Just as the year is ending, the tireless consumer advocacy group CSPI (Center for Science in the Public Interest) has sent a 158 page report to the FDA, entitled Food Labeling Chaos – the case for reform [download PDF]. In it, the organization claims that nutrition labeling today is insufficient, and that existing regulations are too lax to deal with the marketing brainpower of the food industry.

If you have a nutrition label addiction like we do, this report is awesome. The authors break the issues down into 3 areas:

1. Improving the Nutrition Facts Panel
2. Improving ingredient labels
3. Stopping false and misleading health-related claims

They provide examples, from a wide range of product by Kellogg’s , Nestlé, Gerber,  Minute Maid, and others of why regulatory changes are needed ASAP:

Smart Start Cereal by Kellogg’s misleads consumers to believe that half a cup of added sugar a day is approved by the Institute of Health (that’s 125 grams or 600 empty calories!)

Glacéau vitamin water that comes in 20 fl oz bottles misleads people to think that a serving is only 8oz. In fact, most people gulp down the entire bottle receiving 125 calories instead of just 50.

Thomas’ Hearty Grains English Muffins claim to be “made with the goodness of whole grain” and “made with whole grains”, when in fact the primary ingredient is “unbleached enriched wheat flour,” meaning white flour without the benefits of the whole grain (fiber).

“Consumers need honest labeling so they can spend their food dollars wisely and avoid diet-related disease,” said CSPI senior staff attorney Ilene Ringel Heller, co-author of the report. “Companies should market their foods without resorting to the deceit and dishonesty that’s so common today. And, if they don’t, the FDA should make them.”

What you need to know:

The food industry has a very strong lobby and indirectly exerts a lot of pressure on the FDA. Changes will occur slowly, if at all, and the smart folks in the business sector will always find loopholes and tricks to keep consumers just confused enough to want to buy their products.

What to do at the supermarket:

Don’t fall for marketing tricks disguised as nutrition claims. Simply ignore health claims on the front of the package. Read both nutrition facts panel AND ingredient list, to get a better picture of what food you are buying. Buy products with short, understandable, ingredient lists.

HAVE A HAPPY AND HEALTHY NEW YEAR !!!

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Have you noticed the slough of  “quick glance” nutrition information we’ve been bombarded with this year? Whether it’s the calorie count on menu items at fast food chains, or on products or shelves at the supermarket, many new nutrition graphics, icons, and slogans have entered our vocabulary in 2009. NuVal, Smart Choices, Traffic Lights, and a host of other front of pack labels stormed into shoppers’ lives this year (some earlier).

But did they help us improve our choices?

That’s the billion dollar question, which unfortunately does not have a simple answer. Hannaford, a grocery retailer that introduced Guiding Stars several years ago, claims that products marked with at least one “star” showed an uptick in sales. The system provides a score of zero, one, two, or three stars to each an every product sold in Hannaford supermarkets, based on its nutritional value.

NuVal, on the other hand, scores products from 0-100, and is currently offering nutrition information in less than 1000 supermarkets, mostly in the midwest. Anecdotal evidence shows that people are slightly improving choices.

In New York, where calorie labeling in fast food chains such as McDonald’s and Pizza Hut went into effect last year, no changes in people’s habits were recorded so far. And in the UK, where the Traffic Light System has been in use for several years on packaged foods, the verdict is mixed. One study, published by the Food Standards Agency (FSA), the British equivalent of the FDA, showed an improvement in people’s choices. But a recent study by Oxford University researchers showed no correlation between the traffic light symbols and people’s choice of a ready to eat sandwich.

What you need to know:

While the quick glance label may give you quick info, the “information” may not always be in your best nutritional interest. You need to understand that many times the front of pack (FOP) nutrition info is just another marketing tool used by food manufacturers and retailers to get you to think that a product is healthy, when in fact it’s not. The best example is Froot Loops, which received a “Smart Choice” accolade by a consortium of manufacturers and fig-leafs scientists from top universities. This for a cereal with 40% sugar by weight, controversial artificial colors, and trans-fat. Luckily the Smart Choices program was nixed several months after it launched.

There is one very important effect that front of pack nutrition labeling has had though. It has caused food manufacturers to take a look at their products and reformulate them to some extent in order to qualify as many as possible as nutritious. Even Froot Loops lost a bit of sugar and gained a bit of fiber. Granted, these are baby steps, but at least they are in the right direction.

What to do at the supermarket:

Since the front of pack labels have not been approved by the FDA and are not really regulated, there is a lot of wiggle room for manufacturers to sell you a “healthy story” rather than a healthy product.

We recommend that you read the nutrition label itself, along with the ingredient list. It will take another moment of your time, but you will know exactly what you’re getting. And if you need advice or help in choosing a product, Fooducate is always here to help.

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