For the most recent information about food labels, visit FDA's Center for Food Safety and Applied Nutrition.
The right diet is important for everyone, but for Tony Robinson of Orlando, Fla., it truly is his lifeblood.
Robinson has end-stage renal disease. Three times a week, he goes to a local medical center, where a dialysis machine does what his kidneys no longer can: purify his blood.
Between treatments, he's careful about what he eats because some nutrients can cause harmful--sometimes deadly--levels of substances to build up in his blood. He eats a diet low in protein, sodium and potassium to keep these substances--which can be dangerous in his condition--minimal, and high in calories to maintain his weight.
Until recently, he and his wife, who does most of the cooking, kept mainly to foods listed in a brochure of "foods to eat" and "foods to avoid" for people with end-stage renal disease. But now they're using the new food label as another source of information.
"The new label adds to what we already know," Robinson said. "And mandatory nutrition labeling gives us the information we need to choose from a wider range of food products."
Label Benefits
Under the Nutrition Labeling and Education Act of 1990 and regulations from the Food and Drug Administration and the U.S. Department of Agriculture, virtually all food labels must now give information about a food's nutritional content.
That wasn't always the case. Until 1994, nutrition information was voluntary. Manufacturers had to provide it only when a food contained added nutrients or when nutrition claims appeared on the label. Nearly 40 percent of products didn't carry nutrition information.
"Just to have the information on the label is a big plus for consumers on therapeutic diets," said Camille Brewer, a registered dietitian and nutritionist in FDA's Office of Food Labeling.
Another group the regulations help is people with food sensitivities. Every product with two or more ingredients must now list the ingredients on the label. That includes standardized foods, such as peanut butter, and some baked goods. These foods previously were exempt from ingredient labeling because at one time, most Americans were familiar with the recipes since they were foods routinely prepared at home.
Also, the source of some ingredients (for example, hydrolyzed soy protein) must now be identified.
Get the Nutrition Facts
Consumers looking for nutrition information about a food should first look at "Nutrition Facts," usually on the side or back of the package.
For many people on special diets, the amount of the nutrient in grams or milligrams is most important because their diets are based on a set amount of one or more nutrients a day specific to their needs--for example, 60 grams (g) of protein, 2,000 milligrams (mg) of sodium a day. Special dieters can find the amount by weight of nutrients listed in the top part of the Nutrition Facts panel.
Some important points about the Nutrition Facts panel: The values listed for total carbohydrate include all carbohydrates, including dietary fiber and sugars listed below it.
The sugars include naturally present sugars, such as lactose in milk and fructose in fruits, as well as those added to the food, such as table sugar, corn syrup, and dextrose. The label can claim "no sugar added" but still have naturally occurring sugar. An example is fruit juice.
Also, potassium may be listed voluntarily with the nutrients listed on the top part of the panel, just below sodium. Its %Daily Value is based on a recommended intake of 3,500 mg a day.
Other vitamins and minerals may be listed on the Nutrition Facts panel, along with vitamins A and C, iron, and calcium.
Amounts of vitamins and minerals are only presented as percentages of the Daily Value.
Calorie information appears at the top of the Nutrition Facts panel, following serving size information. This information is important for those needing to increase or decrease their calories.
Serving Size
The serving size information gives the amount of food to which all the other numbers on the Nutrition Facts panel apply.
Now serving sizes are more uniform among similar products and are designed to reflect the amounts people actually eat. Also, serving sizes must be about the same for the same types of products--for example, different brands of frozen yogurt--and for similar products within a food category--for example, ice cream, ice milk, and sherbet within the category frozen dairy-type desserts.
Having more uniform serving sizes makes it easier to compare the nutritional values of related foods.
People who follow special diets should be aware that the serving size on the label may not be the same as that recommended for their specific needs. For example, the label serving size for cooked fish is 3 ounces (84 g). A person following a 60-gram protein diet may be allowed only 1 ounce (28 g) of fish at a meal. So, in this case, the nutrient values would have to be divided by 3 to determine the nutritional content of the 1-ounce portion eaten.
Ingredients
The ingredient list is a source of information especially useful for people with food sensitivities. (See Ingredient Labeling: What's in a Food? in the FDA Consumer Special Report "Focus on Food Labeling.") Some new requirements that provide more information in the list are:
Nutrient Claims
Elsewhere on the label, consumers may find claims about the food's nutrient content. Often, these claims appear on the front of the package, where shoppers can readily see them. These claims signal that the food contains desirable levels of certain nutrients.
Some claims, such as "low-sodium" "high in calcium," or "good source of fiber," describe nutrient levels. (See "A Little 'Lite' Reading," in the FDA Consumer Special Report "Focus on Food Labeling.") Some, but not all, highlight foods containing beneficial amounts of nutrients for some people with special dietary needs. The same claim may warn other consumers, for whom the nutrient is detrimental, to avoid the product. For example, a product claiming to be an "excellent source of potassium" is not a wise buy for a person following a low-potassium diet. (See "Nutrient Claims Guide for Individual Foods.")
Health Claims
Health claims describe a relationship between a nutrient or food and a disease or health-related condition. FDA has authorized 10 such claims; they are the only ones that can be used in a label. The claims may show a link between:
The intent of the new food label is not just to ensure that label information is truthful but to provide more complete and useful nutrition and ingredient information for consumers' use. People with special dietary needs will likely find the labeling changes a welcome bonus.
Paula Kurtzweil is a member of FDA's public affairs staff.
Kidney disease
For many people whose kidneys have failed or are failing, protein, potassium and sodium are restricted. The nutrient phosphorus also may be restricted.
People undergoing dialysis may be encouraged to eat 20 to 25 grams (g) of fiber daily because fluid restrictions, lack of exercise, and some kidney medications can cause constipation. The Daily Value for fiber, which is based on a 2,000-calorie diet, is 25 g.
Daily Values are reference numbers based on recommended dietary intakes to help consumers use label information to plan a healthy diet. (See "'Daily Values' Encourage Healthy Diet" in the May 1993 FDA Consumer.)
Liver disorders
People with hepatitis, cirrhosis, and other liver diseases often need a high-calorie, low-protein diet to help rejuvenate the damaged liver and maintain adequate nutrition. They also may need to increase their intake of vitamins--particularly folic acid, vitamin B12, and thiamin--and minerals.
Food sensitivities
According to the Food Allergy Network (a national nonprofit organization), the most common food allergens are milk, eggs, wheat, peanuts and other nuts, and soy. The treatment: avoiding the food or foods containing them.
Celiac disease
This is a genetic disorder in which the body cannot tolerate gliadin, the protein component of the gluten in wheat, barley, rye, and oats. So, people with celiac disease must avoid all products containing these grains--even foods that may contain only small amounts of the protein, such as vinegar, bouillon, and alcohol-containing flavorings. The intolerance leads to malabsorption--not only of the offending food but virtually all nutrients.
Cancer
Because weight loss is common during cancer treatment, many cancer patients need to increase their calories and protein intake.
In the case of bowel obstruction--either from surgery, radiation or the tumor--cancer patients may need to eat less fiber. But, they may need more if they become constipated.
To help reduce their risk of developing cancer again, following treatment, patients may want to choose foods and nutrients whose role in reducing cancer risk has been borne out by significant scientific evidence. (See "Look for 'Legit' Health Claims on Foods" in the May 1993 FDA Consumer.)
Bowel Disease
Increased fiber is often recommended for people with chronic constipation, irritable bowel syndrome, and diverticulosis. Low-fiber diets may be called for during flare-ups of these and other bowel diseases, such as Crohn's disease and ulcerative colitis.
Osteoporosis
In osteoporosis, bone mass decreases, causing bones to become brittle and easily broken, especially in later life. A low-calcium intake throughout life is thought to be a major risk factor. The Daily Value for calcium, based on calcium needs for all ages, is 1,000 milligrams. Vitamin D also is important because it aids calcium absorption. The Daily Value for vitamin D is 400 International Units.
--P.K.
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