The idea of requiring nutrition labels on the front of food packages to disclose sugar and fat content is getting increased attention ahead of the first White House conference in more than half a century on hunger and nutrition policy.

An official task force report informing the conference has included front-of-package nutrition labels in its recommended policy actions. “It would be really silly not to take what was in those recommendations very, very seriously,” said Courtney Gaine, president and CEO of the Sugar Association.

The report specifically calls upon the Food and Drug Administration to “develop an effective front-of-package (FOP) labeling scheme that uses or is based on a transparent, uniform, and science-based nutrient profiling system or specific nutritional parameters.”  

Last month, the Center for Science in the Public Interest submitted a petition to the Food and Drug Administration that spelled out its vision for FOP labels that would be mandatory and nutrient-specific. CSPI further specified the labels should show calories and a graphic or other interpretive feature reflecting levels of added sugars, sodium, and saturated fat per serving.

The bill that provided the funding for the White House conference noted that “levels of hunger, nutrition insecurity, and chronic disease in the United States are rising, and disproportionately afflict racial and ethnic minorities as well as low-income and rural populations." That’s despite 30 years of Nutrition Facts panels on packaged foods. 

Courtney_Gaine_300.jpgCourtney Gaine, The Sugar Association

Gaine, a registered dietician, said The Sugar Association will support “any evidence-based policies,” and she knows the FDA has been conducting focus groups and studies on FOP labels.

But she’s concerned that introducing front-of-pack labeling without associated education around what it’s communicating may not help people improve their diets. Even with the Nutrition Facts panel, she notes, obesity rates and diabetes have not diminished, and the country hasn't realized the anticipated healthcare savings. It’s not that the Nutrition Facts panel was inherently ineffective, she said, “it's just that nobody was educated on how to use it.”

Gaine noted cereal and yogurt makers have slashed their sugar content but haven't gotten credit for it. 

Joe Scimeca, senior vice president of regulatory and scientific affairs at the International Dairy Foods Association, says his group's position is that any front-of-pack labeling should remain voluntary and be "grounded in scientific evidence" and "easily understood by consumers."

IDFA's member companies include yogurt manufacturers such as Danone and Chobani as well as cheese, ice cream, fluid milk and ingredient producers. 

Canada and Mexico already require front-of-package labeling, and Chile requires front-of-package labels for products that exceed limits for sugar, saturated fats and sodium.

Research on Chilean consumers that CSPI cites in its petition to the FDA shows measurable impacts. For example, Eva Greenthal, a senior science policy associate at CSPI, said a behavioral study that monitored how shoppers changed their purchases based on the labels they saw on packages “found that there was a 26% increase in overall healthfulness of selected foods when comparing the groups that viewed foods with nutrient warnings versus a ‘no front of package label’ control." 

Other studies showed decreases in overall purchases of calories, sugars, sodium, and saturated fats among Chilean shoppers.

“I don't think the food industry can say with a straight face that there isn't enough research to support mandatory front-of-package labeling,” Greenthal said. “The call for it in the U.S. has really renewed in recent years and I think that's largely because of the movement around the globe.”

Greenthal and Gaine both note tracing a shopper’s choices at the grocery store through the decades it could take for a disease related to increased sugar, sodium or saturated fat intake to manifest would be challenging research. Yet Gaine would like to see a better attempt to quantify how labels correlate to health.

“I would just like to see a million-dollar study, which seems like a lot of money, but it's not really for something that is supposedly going to cure everybody,” Gaine said.

Plus, she’s concerned that without being precise about desired outcomes, the downstream impacts could be different than expected. As an example, she points to the notion of “reformulation,” the idea that food processors will change their recipes to either comply with new rules — as many did in anticipation of the ban on trans fats in foods — or to prevent certain negative-seeming labels from being applied.

For example, if a new front-of-package label were to set a threshold for how many grams of added sugar would prompt a visual image such as a stop sign, a company might choose to reduce the sugar amount per serving just slightly to avoid that label.

CSPI, on the other hand, sees reformulation as one of the desired outcomes of front-of-package labels.

Even if a company brings a product to just below the level that would require some additional labeling “that's still a change in the food supply that could have a substantial benefit," Greenthal said.

But Gaine said companies might also substitute other ingredients, such as non-nutritive sweeteners, such as stevia, aspartame, sucralose or sorbitol, to skirt the label. Front-of-package label proposals usually focus on added sugars, saturated fats and sodium.

“When you just focus on the three nutrients of concern, you're not seeing the entire package of a food. So then, all of a sudden, are children going to not get fiber because they're not buying the cereal because there's an added sugars warning label on the front of it?”

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While she recognizes that reformulation could have a meaningful impact on what people eat, Gaine is hesitant to accept that’s inherently going to be a net positive.

“When are we going to learn a lesson that these things don't happen in isolation and the whole picture has to be viewed on, ‘how do you make food?’” She’s hopeful food scientists and dieticians will be around the table when public health officials and policymakers reach any conclusions. “You need to have a diverse group of experts representing all sides of how food is made and how it ends up in people's mouths.”

Meanwhile, the Consumer Brands Association, which represents food manufacturers, and FMI - The Food Industry Association, which represents retailers and other food industry voices, have their own voluntary labels for the fronts of packages. Facts Up Front is a system that can show both nutrients of concern and nutrients to seek out, such as potassium or fiber. The labels appear on a range of products, including cereal, granola bars and taco shells.

“Consumer Brands supports fact-based labeling solutions that have proven benefit to consumers and easy to understand information,” Sarah Gallo, vice president of product policy for the association, said in a statement to Agri-Pulse. Facts Up Front complies with existing labeling requirements and Gallo points out it can be modified to meet changes to dietary guidelines.

Sarah GalloSarah Gallo, Consumer Brands Association

Regardless of whether something specific about front-of-package labels comes out of the White House conference, CSPI’s petition is still with the FDA – with more than 2,700 public comments so far – and front-of-package labels have support in Congress. The Food Labeling Modernization Act was introduced by Rep. Frank Pallone, D-N.J., in the House and Sen. Richard Blumenthal, D-Conn., in the Senate.

While the path to mandatory front-of-package labeling remains long, Greenthal is confident clear, concise and contextual information on the front of a package will help consumers eat better.

“We think that's really promising in terms of having that nudge, that behavioral nudge, for consumers to say, ‘you know, maybe pick this not that’ or ‘maybe buy that less often or less of it,’” she said. And with varying levels of English literacy and nutritional knowledge across the population, she sees “a simplified, quick and easy message as facilitating more equitable access to nutrition information.”

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