The Tufts University Friedman School of Nutrition Science and Policy is one of the nation’s foremost leaders in the field of nutrition. They are hosting the 4th annual Friedman Symposium this weekend, a 2 day affair devoted to current affairs in the nutrition and diet arena.

Fooducate was lucky to partake in the conference as an online participant. (thank you Mark Krumm,  Director, Events & Marketing at Tufts, for helping set us up).

Judging from the titles and professional experience of the presenters and lecturers present, the people seated at the Jaharis Conference Center represented a highly capable group. Could some magic happen here that would help put America back on the health track? Read more…

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Meijer is rolling out what it hopes will be another helpful means for consumers to assess the nutritional quality of foods at the supermarket. NuVal assigns a score of 0-100 to food products based on a proprietary algorithm called ONQI (overall nutritional quality index) developed by top nutrition experts.

According to Dr. David Katz, the scientist behind ONQI / NuVal, the values of  30 nutrients in a food product are crunched in a formula that yields a final score. Nutrients to encourage, such as fiber and vitamin C, increase the score, while saturated fats and sugars reduce it.

As would be expected, vegetables and fruits score high, milk and meats lower, and most processed foods the lowest.

What you need to know:

We covered NuVal in detail when it launched several months ago,  commenting on both the positive and negative aspects of such a system.

On the bright side, the system provides a simple, intuative, front of label indication of a food’s health value.

On the other hand, there is an inherent conflict of interests between retailers and consumers. Most consumers, we assume, want to eat healthy. But retailers want to sell them as much as possible and at high margins. Unfortunately the most profitable products are processed foods (Soft drinks are a great example: water, colors and sugar – very profitable).The healthy foods, less processed, fruits vegetables, grains, and basics like milk and meats, do not carry a high profit margin. For a retailer, steering its customers to healthier products is then, essentially, like someone shooting himself in the foot.

Perhaps this is why NuVal, which hoped to have 15-20 retailers on board by now, can count Meijer only as its third partner, following limited launches at Hy-Vee and Price Chopper in January.

What to do at the supermarket:

Most Americans will have to wait till NuVal hits their local grocery store. So diligent shoppers will have to continue checking the ingredient lists and nutrition labels to make sure they know exactly what they are putting on their families’ plates.

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Price Chopper introduces NuVal

Northeast supermarket chain Price Chopper, is rolling out NuVal, a nutritional scoring system today. The 114 store chain operates in New York, Connecticut, Massachusetts, Vermont, New Hampshire, and Pennsylvania.

The aim of NuVal and other nutritional scoring systems is to simplify the task of choosing healthier foods at the supermarket.

The NuVal approach is especially easy to understand – each product gets a score from 1 (lowest) to 100 (highest) based on the presence of “good” and “bad” nutrients. The system, originally known as ONQI (Overall Nutritional Qulaity Index), was developed by a respectable team of scientists led by Dr David Katz.

We posted a detailed analysis of NuVal’s pros and cons, as well as its competitors, a few months ago.

NuVal and Price Chopper have been testing the system out for some time, and today is the official launch. Another chain currently implementing NuVal is Hy-Vee.

Regional Price Chopper competitors have also boarded the health wagon, with Hannaford Brothers’ intorduction of Guidign Stars in 2006, and Stop & Shop’s Healthy Ideas launced earlier this month.

What to do at the supermarket:

While a quick glance score can help you get an idea as to the healthfulness of a specific product, some aisles are going to rank much better than others. As always, your best bets are minimally processed foods, which are usually found in the supermarket perimeter, not the inner aisles.  Also look for foods with short ingredient lists that you can actually understand.

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The new year has ushered in a blizzard of new food labeling systems aimed at helping consumers make healthier choices at the supermarket. This week it is Supervalu, which kicked off nutritionIQ at its California Albertsons stores.

The color-coded, easy-to-spot shelf tags, or cards, are supposed to aid shoppers in choosing low fat, high fiber and other good foods. From the SuperValu press release:

The program covers 11 different nutrient claims in seven categories with the shelf tags color-coded as follows:
• excellent or good source of fiber are denoted by orange tags,
• excellent or good source of calcium by blue tags,
• excellent or good source of protein by yellow tags,
• low or healthier level of sodium by dark green tags,
• low calorie by a purple tag,
• low saturated fat by a red tag and
• whole grains by a dark orange tag.

read the full press release…

It seems that in the last few months, simplifying food labels has become a must for all grocery chains and manufacturers. NuVal, GDA, Nutritional Spotlight, and Smart Choices are recent examples. For more details, read our history of product nutrition labeling. While easy to understand nutrition information is to be commended, consumers may become befuddled by the tower of nutritional babel.

The new system has been developed in cooperation with Joslin Clinic, part of an academic medical center affiliated with Harvard Medical School.

What you need to know:

Supervalu should be commended for taking this first step, showcasing the more nutritious foods in the supermarket. But will they also place signs on foods that are really not nutritious? Don’t hold your breath.

As a supermarket that needs to sell more, not less products, don’t expect Albertson’s to post NutritionIQ signage with negative nutritional information. In fact, Supervalu does not even plan to apply the benchmarks to snacks or beverages, where there is no chance to find nutrition.

What to do at the supermarket:

Although nutritionIQ tags simplify things for shoppers, always check the nutrition label as well to learn about the nutrients to limit. Many times low-fat means high in sugar. But the tag won’t necessarily tell you that.

In general, it’s best to select products with short ingredient lists. Unprocessed foods are easy to find at the supermarket. Just stick to the perimeter of the store, where you will find fresh fruit and vegetables, whole grains, low fat dairy and low fat cuts of meat.

Don’t be let simplifications created by the supermarket or a munufacturer catch you off guard. Remember, they want you to buy more, not less.

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The NuVal Nutritional Scoring System has updated its website to include sample score of hundreds of everyday items. We posted about NuVal and its competitors a few months ago.  These nutrition scoring systems aim to simplify the task of choosing healthier foods at the supermarket.

The NuVal approach is especially easy to understand – each product gets a score from 1 (lowest) to 100 (highest) based on the presence of “good” and “bad” nutrients. The system, originally known as ONQI (Overall Nutritional Qulaity Index), was developed by a respectable team of scientists led by Dr David Katz.

Here are some interesting facts:

The top scoring category, unsurprisingly, is fruits and vegetables, with all products scoring 78 to 100, except for coconut, with a mere 24. Could this be a mistake?

The cereal section has products with scores as low as 4, and as high as 100. Hodgson Mill Unprocessed Wheat Bran scores a perfect hundred, but do you know any kids who’ll eat it? Sadly for this blog’s editor, a childhood favorite, Cap’n Crunch, gets a lowly score of 10.

The worst scoring categories are cookies (1-40) and salty snacks(1-52). Cheetos get a measly 5, Doritos a 10. The top scorer is Garden Of Eatin No Salt Blue Tortilla Chips Made With Organic Blue Corn with a score of 52.

Vegetables, either frozen or canned, score anywhere between 2-100, based on their original “fresh score” plus consideration of the nutrition reduction caused by freezing or canning. Canned vegetables usually get plenty of added salt as a preservative and flavor enhancer, but unfortunately this lowers their score.

What to do at the supermarket:

If you are pondering which cereal to choose from, perhaps NuVal can help you. Right now, the shelf display scoring system is being tested at Price-Chopper and Hy-Vee. Rollout in other groceries has been expected in fall 2008, and early 2009, but it perhaps the logistical challenges are causing some delays. If you have come across an NuVal score that helped you make a halthier shopping decision, please share with us.

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flickr photo: Laurel Fan

Who hasn’t been told to cut down on fatty food, cholesterol, salt, sugar, and “practically everything that tastes good”. After a while, people just ignore these warnings because it seems that there is nothing healthy left to eat. After several decades of “negative” nutritional messages, messages encouraging people to eat foods with positive nutrients are becoming more prevalent. Products are not just touting low fat content, they are also boasting high levels of fiber, omega-3, and other goodies.

One group that has been an active player in the “Yes to good food” camp rather than the “No to bad food” approach is the Nutrient Rich Foods Coalition. The NRFC is a not-for-profit organization that represents for-profit commodity growers in the US, including the National Dairy Council, the California Avocado Commission, the Wheat Council, and others. All 5 major food groups are in.

We recently spoke with Dr Greg Miller, a spokesperson for the NRFC. Dr Miller is an executive vice president of the National Dairy Council. In our conversation we discussed the coalition’s approach to nutrition information, as well as dairy specific issues (we’ll write about those in a separate post).

The Nutrient Rich Foods Coalition formed about 5 years ago with the goal of creating a paradigm shift in nutrition education. The idea is to move away from 30 years of negatives, to a more encouraging focus on foods with maximum good nutrients per calorie. Some foods pack lots of health into a low number of calories. Others, called junk foods, fill people up with empty calories. The coalition funded several academic studies to explore various ways of defining which foods are nutrient dense and which are not.

An algorithm that was developed by Professor Adam Drewnowski, Director, Nutritional Sciences Program, at the University of Washington, exemplifies this approach. Called NRF9.3, this algorithm uses a food product’s levels of 9 nutrients to encourage and 3 nutrients to limit, and then calculates a nutrition score. The nutrients are those appearing on a packaged food’s nutrition label. They are protein, fiber, vitamin A, vitamin C, vitamin E, calcium, iron, potassium, magnesium, fats, sodium, and sugars.

Various products can be compared based on their nutrition score. According to Dr. Miller, the algorithm has been validated against the Healthy Eating Index and found to have statistically significant correlations between high scoring foods and better health.

The NRFC is taking an approach similar to that of NuVal / ONQI which we covered a few weeks ago. However, NRFC does not have a retail roll-out planned at this time. The organization is currently focused  on educational and informational activities.

Cynics will say that any organization representing the food industry will prefer messages that encourage eating more (even if more of good foods) rather than messages of “eating less”, this despite the fact that most Americans need to reduce their daily caloric intake. What is clear to the NRFC, as well as anybody dealing with nutrition today, is that consumers are confused about what to eat and what not to eat. They will welcome a solution that makes it easier to choose better foods. And if a system that encourages eating real foods works for people, great.

Some suggestions from the NRFC include:

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Have you ever wondered what’s inside that tasty TV dinner, instant pudding, or granola bar? How healthy, or not? Theoretically, we can learn a lot about a packaged food item just by reading its nutrition panel. Unfortunately for many of us, the nutrition information, ingredient list, and health claims on the package tend to confuse more than elucidate. As a result, consumers make misinformed purchase decisions. Several labeling initiatives have recently launched with a mission to simplify the nutrition information for consumers. (For some background, check our post about the history of food labels.)

A few days ago we reviewed the brand new Smart Choices Program. Today, a look at another front of package labeling system – NuVal (Nutritional Value Scoring System). NuVal was announced in late 2007 as ONQI (Overall Nutritional Quality Index). It is a scoring system that rates food on a scale of 1-100. The higher the score, the more nutritious the product.

The proprietary system consists of an algorithm that inputs values of over 30 different nutrients (i.e. protein, carbs, fats, vitamins, and minerals), and outputting a single score. The system looks at “nutrients to encourage”, such as fiber and omega-3 fatty acids, as well as “nutrients to avoid” such as saturated fat and sodium.

The NuVal score is displayed at the supermarket on shelf tags and aisle signage, but not on the product package itself. NuVal was supposed to launch earlier this summer with several grocery chains. After a slight delay, Hy-Vee, a midwestern chain out of Iowa, was recently announced as a partner. Price Chopper has joined in the North East. Both are limited launches though – only several stores and several product categories are offered now.

NuVal / ONQI is the brainchild of Dr. David Katz, a Professor of Public Health Practice, and a nationally recognized expert in the fields of weight control and nutrition. He was previously Director of Medical Studies in Public Health, at the Yale University School of Medicine. Dr. Katz assembled a top notch team of researchers to create the ONQI system, and it took them 2 years to do it. The grading algorithm itself has not been disclosed to the public.

NuVal LLC is  a joint venture of Yale university’s Griffin Hospital and Topco Associates, a privately held cooperative of food retailers and wholesalers. Unlike “Smart Choices”, food manufacturers are not part of this initiative, although the ONQI score requires additional information from manufacturers that is not found on food labels.

The good:

1. Simplicity. Everyone can relate to a numeric score of 1-100.

2. Uniformity. A single scoring system across all products enables consumers to compare apples to oranges, literally. (not that it would make any sense – both are nutritious and tasty).

3. Depth. A NuVal score of 1-100 provides more breadth to a product’s healthfulness than a Yes/No benchmark that appears only on selected items. Assuming all products in a supermarket will carry a NuVal score, consumers will readily compare between items in a category and choose the one with highest ranking.

4. Independence. Although not mentioned explicitly, it seems that food manufacturers were not directly involved in defining the NuVal scoring algorithm. Hopefully this sets a higher rating standard, more in favor of consumers than in the interests of manufacturers.

The not so good:

1. Mystery Scoring. NuVal is not disclosing its scoring mechanism. Smart Choices posted their criteria online, and those interested can understand exactly why one product is eligible for a check mark, and the other is not. According to NuVal, its algorithm is patent pending (which means it will be published by the US patent office once it is approved). If so, why not publish it now so consumers can be confident in their choices?

2. Manufacturer Buy In. Some of the nutrients used by the NuVal algorithm do not uniformly appear on food nutrition labels (i.e. omega-3, Total bioflavanoids, vitamin B12).  This means either the algorithm can’t calculate scores uniformly within a product category, or that all manufacturers need to provide additional nutrient information to NuVal, a third party. The chances for that happening are slim, especially for those already comitted to Smart Choices.

3. Retailer Buy In. What happens if best selling products in the supermarket get low scores? Will retailers willingly want to lose sales of soda pop and salty snacks because of their single digit score? Or are they betting that customers won’t care?

4. Placement. This may seem trivial, but in those supermarkets where price is displayed on the shelf instead of on the product, there are always mismatches. Put NuVal indicators on the shelves and you’ve added another level of complexity to bleary eyed associates stocking shelves at 4am. With Smart Choices, the approval seal is on the product package itself.

5. No personalization. This is an issue with Smart Choices as well. A middle aged diabetic has different dietary needs than a healthy teenager or a senior suffering from hypertension and trying to reduce sodium intake. How can a low-fat fruit yogurt have the same score for each of them? Ideally, a person would see a personalized score for each product.

Conclusion:

The teams behind NuVal and Smart Choices have made good headway in simplifying a very complex nutrition label and boiling it down to very simple indicator for consumer decision. Both systems sport some flaws, but having them at a supermarket seems to be better than not having them at all.

As the goal of both Smart Choices and NuVal is to become a nationwide standard, it will be interesting to see how the imminent competition between the two systems will play out. Also interesting to look for are the FDA’s actions. Will the FDA choose to create some sort of uniform benchmark like the UK’s Food Standard Agency Traffic Lights?

What do you think? Comments below.

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Updated: October  2009. Original version published in November 2008.

In the early 13th century, the king of England proclaimed the first food regulatory law, the Assize of Bread, which prohibited bakers from mixing ground peas and beans into bread dough. Ever since, it has been a cat and mouse game between the food industry and the public (fast forward to China 2008 – cheap poisonous melamine in milk powder). In the US, food regulation dates back to early colonial times. Here is a brief overview of the last 150 years of government and industry food regulation:

1862 President Lincoln launches the Department of Agriculture and the Bureau of Chemistry, the predecessor of the Food and Drug Administration.

1906 The original Food and Drugs Act is passed. It prohibits interstate commerce in mis-branded and adulterated foods, drinks and drugs.

1906 In the aftermath of “The Jungle” by Upton Sinclair, which detailed the horrendous sanitary and working conditions in the meatpacking industry, the Meat Inspection Act is passed.

1924 The Supreme Court rules that the Food and Drugs Act condemns every statement, design, or device on a product’s label that may mislead or deceive, even if technically true.

1938 A revised and expanded Federal Food, Drug, and Cosmetic (FDC) Act of 1938 is passed. Highlights include: safe tolerances to be set for unavoidable poisonous substances, standards of identity, quality, and fill-of-container to be set for foods, and authorization of factory inspections.

1939 First Food Standards issued (for canned tomatoes, tomato purée, and tomato paste).

1949 FDA publishes guidance to industry for the first time, called “Procedures for the Appraisal of the Toxicity of Chemicals in Food,” (aka the “black book”)

1950 Oleomargarine Act requires prominent labeling of colored oleomargarine, to distinguish it from butter. (Yes, swindlers tried to sell folks cheap margarine in the guise of butter.)

1958 Food Additives Amendment enacted, requiring manufacturers of new food additives to establish safety. Going forward, manufacturers were required to declare all additives in a product.

1958 FDA publishes the first list of food substances generally recognized as safe (GRAS).

1962 President Kennedy proclaims the Consumer Bill of Rights. Included are the right to safety, the right to be informed, the right to choose, and the right to be heard.

1965 Fair Packaging and Labeling Act requires all consumer products in interstate commerce to be honestly and informatively labeled, including food.

1971 Artificial sweetener saccharin, included in FDA’s original GRAS (generally recognized as safe) list, is removed from the list pending new scientific study.

1973 California Certified Organic Farmers (CCOF) is formed. Begins with 54 farmers mutually certifying each other’s adherence to its own published, publicly available standards for defining organic produce.

1977 Bowing to industry pressure, the Saccharin Study and Labeling Act is passed by Congress to stop the FDA from banning the chemical sweetener. The act does require a label warning that saccharin has been found to cause cancer in laboratory animals.

1980 Infant Formula Act establishes special FDA controls to ensure necessary nutritional content and safety.

1980 The USDA Food and Nutrition Information Center (FNIC) publishes the 1980 Dietary Guidelines for Americans. The guidelines are to be updated every 5 years. In 1980 there were 7 relatively simple guidelines. In the 2005 Dietary Guidelines for Americans, there were 41 recommendations in a 71 page booklet!!!

1982 FDA publishes first “red book” (successor to 1949 “black book”), officially known as “Toxicological Principles for the Safety Assessment of Direct Food Additives and Color Additives Used in Food”.

1990 Nutrition Labeling and Education Act (NLEA) is passed.  It requires all packaged foods to bear nutrition labeling and all health claims for foods to be consistent with terms defined by the Secretary of Health and Human Services. As a concession to food manufacturers, the FDA authorizes some health claims for foods. The food ingredient panel, serving sizes, and terms such as “low fat” and “light” are standardized. This is pretty much the nutrition label as we know it today.

1991 Nutrition facts, basic per-serving nutritional information, are required on foods under the Nutrition Labeling and Education Act of 1990. Food labels are to list the most important nutrients in an easy-to-follow format.

1995 Saccharin Notice Repeal Act repeals the saccharin notice requirements of 1977. People can get their saccharin without having to read about its risks.

1995 American Heart Association initiates a food certification program including AHA’s Heart Check Symbol to appear on certain foods.  Criteria is simple – low in saturated fat and cholesterol for healthy people over age 2. Oh and also, a certification payment to AHA by the food manufacturer. Now you know why sugary cereal is Heart Checked.

1998 Transfair, the US Fair Trade organization is established, with a mission “to build a more equitable and sustainable model of international trade that benefits producers, consumers, industry and the earth”.

2002 The 2002 Farm Bill requires retailers provide country-of-origin (COOL) labeling for fresh beef, pork, and lamb. After repeated debilitation and stakeholder pressures, the law would finally go into effect only 6 years later, on Oct 1, 2008, and even then with many loopholes.

2002 The National Organic Program (NOP),  enacted. It restricts the use of the term “organic” to certified organic producers. Certification is handled by state, non-profit and private agencies that have been approved by the US Department of Agriculture (USDA).

2003 Announcement made that FDA will require food labels to include trans fat content. Labeling went into effect in 2006.

2003 The FDA announced plans to permit the manufacturers of food products sold in the United States to make health claims on food labels which are supported by less than conclusive evidence. From “significant scientific consensus” before a claim can be made, industry can now rely on “Some scientific evidence” or “Very limited and preliminary scientific research” to make a health claim. Opponents criticize it as opening the door to ill-founded claims. Advocates believe it will make more information available to the public.

2004 Passage of the Food Allergy Labeling and Consumer Protection Act. Requires labeling of any food that contains one or more of: peanuts, soybeans, cow’s milk, eggs, fish, crustacean shellfish, tree nuts, and wheat.

2004 PepsiCo launches Smartspot – designating the “more nutritious” of its products with an easy to spot symbol on the front of package. Baked Doritos in. Fried Doritos out.

2005 Kraft launches Sensible Solutions, a similar initiative for its gamut of products including sugar-free Jello, vitamin water, and Nabisco toasted chips.

2005 President’s Choice launches Blue Menu to designate its healthier products.

2006 Hannaford Brothers Supermarket Chain launches Guiding Stars intended to help customers choose healthy foods. Foods are ranked 0 to 3 stars, with three stars awarded to most nutritious foods. Only 20% of the supermarket stocked items are starred, but sales of these items increase by several percentage points.

Sept 2008 NuVal announced – The nutritional value (NuVal) System scores food on a scale of 1 to 100. The higher the NuVal Score, the higher the nutrition of a food product. The score is based on a complex and *top secret* Overall Nutritional Quality Index (ONQI) that takes into account 30 different nutrients in food. [update: read review]

Oct 2007 Kellogg’s Launches Nutrition at a Glance based on the European Guideline Daily Amounts (GDA) system. Front of Package information includes daily percentage values for 6 nutrients: calories, total fat, sodium, sugars, vitamin A, and vitamin C.

Oct 2008 Mars International launches GDA labeling of its foods and snacks in the US.

Oct 2008 Smart Choices launched – a pan industry effort to promote a standardized benchmark for front of package consumer information. Initial supporters include General Mills, Con-Agra, Coca-Cola, PepsiCo, and Unilever. [update: read review]

January 2009 Healthy Ideas launched at Giant Foods and  Stop & Shop supermarkets. Around 10% of the items qualify for this benchmark, developed by the grocers’ nutrition experts and based on FDA and USDA guidelines.

January 2009 Sara Lee introduces Nutritional Spotlight front of package labels for bread, bun, and bagel products. This move is in contrast to an industry wide attempt by manufacturers to create a unified Smart Choice label. This label is similar to Mars’ and Kelloggs’ recent efforts.

January 2009 SuperValu introduces nutritionIQ shelf signage at its Albertsons stores. The color-coded, easy-to-spot shelf tags, or cards, are supposed to aid shoppers in choosing low fat, high fiber and other good foods.

January 2009 Regional Grocery Chain, United Supermarkets, Introduces TAG Nutrition Labeling Program. Five color coded shelf labels point to Heart Healthy/Diabetes Management, Gluten-Free, Organic, Lean/Low-Fat for Meat and Dairy and Sugar-Free/Reduced Sugar products.

June 2009 – SuperValu introduces Healthy Elements program for its independent retail partners.

Summer 2009 – Smart Choices launches formally with several hundreds of products labeled with the green check mark. Froot Loops becomes the poster child for everything wrong with an industry backed nutrition rating system.

October 2009 – The FDA sends a “Dear Manufacturer” letter to boards of the Smart Choices Program and other Front of Pack nutrition rating systems, stating its concern with the potential to mislead consumers. A week later the Smart Choices program suspends itself.
What’s next for food labels? Consumers interest groups will continue to demand more visibility and more information from manufacturers. More data will become available, but translating the wealth of information to a decision at the supermarket shelf will not necessarily become easier for consumers. Programs such as Guiding Stars and NuVal may help consumers make better decisions, but with the FDA’s renewed interest and vigor, perhaps we shall see a uniform, standardized format on all products in the not too distant future.

Visionaries see a day where each ingredient of every product on a shelf can be connected directly to the farm, factory, and other stakeholders involved in its processing. Now how do you fit all that information on a pack of gum?

Sources: FDA, USDA, AHA, company and organization websites

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