“To say they [the data] are imperfect is the equivalent of saying the Titanic had a floatation problem or a buoyancy problem.”
Earlier this week, news broke that the Food and Drug Administration is finally set to release new guidelines on nutrition labels, 20 years after it implemented the current ones. This move is huge. Not only does it affect every single food producer in the United States (in having to redesign product packaging), it could also stand as a paradigm shift in the way Americans think about nutrition.
For instance, if “added sugar” is highlighted more prominently on the label, as some are reporting it might be, that would codify sugar as being public-health enemy No. 1. If it provides consumers with more realistic serving sizes, it might induce second thoughts about purchasing that pint of ice cream that says it is five servings (but we all know what will really happen there).
The nutrition labels as we know them have been around since 1994, when the 1990 Nutrition Labeling and Education Act went into effect. But nutrition is a slippery science, dependent on self-reported datasets for decades. What we “knew” just a few years ago — for example, that eggs are bad for heart disease — doesn’t necessarily hold true today. And public understanding of nutrition is further diluted by the promises of fad diets.
Which is to say that the prospect of creating a nutrition labels that reflects solid science and can remain valid for decades is fraught. Add to that challenge, the task to make that information salient to people without overwhelming them, and the task seems downright impossible.
But change is needed. Here’s why our current labels are so flawed:
1. There’s no one standard way to measure a calorie.
Say you are looking at two bags of chips. Both weigh the same, and presumably contain the same amount of chips. One bag has 300 calories, the other has 360. Which one actually has the lower caloric amount? Right now, it’s impossible to tell.
That’s because the FDA allows for five different ways to measure total calories and allows for a margin of error of up to 20 percent. Basically, a manufacturer can either use predetermined conversions (one gram of carbohydrate is four calories) or burn the product to see how much energy that comes off. These will provide different values.
And the FDA doesn’t have the greatest track record of oversight on the label values. In 2008, a Government Accountability Office report found “FDA’s testing of nutrition information has been limited and has found varying degrees of compliance.” Although 87 percent to 91 percent of labels were in an allowable range in an audit, “compliance rates varied significantly for a few nutrients.” Only 47 percent of labels were in the correct range for the amount of Vitamin A they contained.
2. Percent daily values are based on very shoddy data
Much about what we “know” about nutrition comes from a four-decades-deep dataset called the National Health and Nutrition Examination Survey, or NHANES, which is comprised of self-reported data. And from this, basic correlations emerge, like how high-fat diets are linked to higher weights, and so on. The survey has also given us a picture of what the average human eats. Those values, in turn, are reflected in nutrition policy.
But it turns out that people are horrible about accurately reporting their food intake.
“To say they [the data] are imperfect is the equivalent of saying the Titanic had a floatation problem or a buoyancy problem. These data should not be used,” says Edward Archer, an obesity researcher, who authored a scientific takedown of the NHANES data in the Journal PLOS One.
That’s because people would commonly report levels of food that are incapable of maintaining human life. “In no survey did at least 50 percent of the respondents report plausible [energy intake] values,” Archer and his coauthors concluded in their study.
3. Serving sizes do not reflect reality.
According to the Center for Science in the Public Interest, a watchdog group, data on serving size comes from a 20-year old survey (again, using self-reported data) from the Agriculture Department. “Fourteen newer food consumption data show that consumers are eating larger portion sizes than they did in the 1970s and 1980s,” the center wrote in its 2010 case for nutrition facts reform.
For instance, under current regulations, a serving size of ice cream is half a cup. Try scooping only that amount.
4. Information can be overwhelming.
You can give people numbers, but those numbers may not be salient in terms of changing behavior.
In the 2008 report, GAO found that consumers “generally found nutrition labeling confusing.” And while 30 percent of consumers say they will look at a nutrition label when purchasing an item, an eye-tracking study found that only 9 percent will look at the calorie counts when reading a label.
In 2003, the FDA started researching the problem to try to make the nutrition information more salient. “One consistent finding … was that participants don’t like to do math, and they often make mistakes when determining the caloric and nutritional content of packaged food,” Amy Lando, an FDA researcher said in a podcast. The agency found that consumers were likely to make better decisions when a serving size reflected the container size or when the label had an additional column with the entire caloric count of the container (which may be a hint as to what the new labels will look like).
“It appears that information is not one of the main obstacles to people eating well,” Julie Downs, a researcher at Carnegie Mellon University, told me. She led a study that found no changes in behavior after the implementation of calorie counts in a fast-food restaurant. While that’s not the same thing as buying groceries, she thinks the concept carries over.
We don’t think of food in terms of numbers, and it’s hard to put 300 calories in the context of an entire day. It’s even harder, considering that individual factors play a huge role. As Archer explains, “Putting a number on a box isn’t going to tell that person what their body is going to do with the food.” For some people, sodium is a problem, exacerbating high blood pressure. For others, it’s not. Those who are physically active metabolize food differently than those who are more sedentary. And we haven’t even waded into the debate over whether all calories are created equal.
The new recommendations will be released tomorrow. Good luck, FDA.