How can people with diabetes use the food label to help with their diets?

How beneficial the new label will be for people with diabetes depends on the type of meal plan they follow. Today, diabetes experts no longer recommend a single diet for all people with diabetes. Instead, they advocate dietary regimes that are flexible and take into account a person's lifestyle and particular health needs.

The American Diabetes Association recommends these general dietary guidelines for people with diabetes:

• Limit fat to 30 percent or less of daily calories.

• Limit saturated fat to 10 percent or less of daily calories.

• Limit protein to 10 to 20 percent of daily calories. For those with initial signs of diabetes-induced kidney disease, restrict protein to 10 percent of daily calories.

• Limit cholesterol to 300 milligrams or less daily.

• Consume about 20 to 35 grams of fiber daily.

Considering these factors, how should people with diabetes go about using the new food label?

They can begin with the Nutrition Facts panel, usually on the side or back of the package. A column headed %Daily Values shows whether a food is high or low in many of the nutrients listed.

People with diabetes should check the %Daily Values for fat, saturated fat, and cholesterol. As a rule of thumb, if the number is 5 or less, the food may be considered low in that nutrient.

The goal for most people with diabetes is to pick foods that have low %Daily Values for fat, saturated fat, and cholesterol and high %Daily Values for fiber. Other label nutrition information can help people with diabetes see if and how a food fits into their meal plan.

The serving size information gives the amount of food to which all other numbers on the Nutrition Facts panel apply.

Serving sizes now are more uniform among similar products and reflect the amounts people actually eat. For example, the reference amount for a serving of snack crackers is 30 g. Thus, the serving size for soda crackers is 10 crackers and for Goldfish Tiny Crackers, 55, because these are the amounts that come closest to 30 g.

The similarity in serving sizes makes it easier to compare the nutritional qualities of related foods.

People who use the Exchange Lists should be aware that the serving size on the label may not be the same as that in the Exchange Lists. For example, the label serving size for orange juice is 8 fluid ounces (240 milliliters). In the exchange lists, the serving size is 4 ounces (one-half cup) or 120 mL. So, a person who drinks one cup of orange juice has used two fruit exchanges.

The Nutrition Facts panel also gives total calories and calories from fat per serving of food. This is helpful for people who count calories and monitor their daily percentage of calories from fat.

The label also gives grams of total carbohydrate, protein and fat.

The values listed for total carbohydrate include all carbohydrate, including dietary fiber and sugars listed below it. Not singled out is complex carbohydrates, such as starches.

The sugars include naturally present sugars, such as lactose in milk and fructose in fruits, and those added to the food, such as table sugar, corn syrup, and dextrose.

The listing of grams of protein also is helpful for those restricting their protein intake, either to reduce their risk of kidney disease or to manage the kidney disease they have developed.

Elsewhere on the label, consumers may find claims about the food's nutritional benefits. Often, these nutrient content 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 fat," "no saturated fat," and "high fiber," describe nutrient levels. See "A Little 'Lite' Reading," in the June 1993 FDA Consumer.) Some of these are particularly interesting to people with diabetes because they highlight foods containing nutrients at beneficial levels.

Other claims, called health claims, show a relationship between a nutrient or food and a disease or health condition. FDA has authorized nine such claims; they are the only ones about which there is significant scientific agreement. There are also other health claims under consideration at this time.

Two that relate to heart disease are of particular interest to people with diabetes:

• A diet low in saturated fat and cholesterol may help reduce the risk of coronary heart disease.

• A diet rich in fruits, vegetables and grain products that contain fiber, particularly soluble fiber, and are low in saturated fat and cholesterol may help reduce the risk of coronary heart disease.

Nutrient content and health claims can be used only under certain circumstances, such as when the food contains appropriate levels of the stated nutrients. So now, when consumers see the claims, they can believe them.