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“As consumers shop for healthier food, they encounter confusion and frustration,” former U.S. Health and Human Services Secretary Louis Sullivan remarked in 1990. Dr. Sullivan was lamenting the inadequate state of food labeling, which he said required consumers to be “linguists, scientists, and mind readers” as they perused shelves and tried to make healthy selections.
The bipartisan Nutrition Labeling and Education Act passed by Congress that year led to the creation of the Nutrition Facts label that now appears on billions of food and beverage products. It was a landmark step, but more than three decades later; the United States continues to experience high rates of diet-related illness and disease that contribute to astonishingly high healthcare costs and put a drain on the economy — in part because consumers still struggle to determine whether the products they buy are healthy. To make it easier for consumers to make healthy choices, the United States should adopt a mandatory front-of-pack nutrition labeling system that gives consumers clear, concise, and easy-to-find information about their food options. And the food and beverage industry should welcome front-of-pack labeling and join the cause. Making it easier to identify healthy choices is good for consumers, improves overall health, and benefits the healthcare system and the economy.
Good nutrition starts with education. Appearing on more than 6.5 billion products, the current Nutrition Facts label includes the number of calories and servings for a given product, specific nutrients, and how much those nutrients contribute to an overall daily diet. People who use the label buy more fruits, vegetables, and whole grains — and fewer sugary drinks — compared to those who don’t. Recent changes to the label, such as the inclusion of added sugars, have made it stronger.
The problem is that fewer than 1/3 of consumers report using it. Those who do tend to be white, with higher incomes and more education; among its most infrequent users are parents of young children. Many people — including Food and Drug Administration (FDA) Commissioner Robert Califf — don’t pay much attention to it for a simple reason: it appears on the back of packages, not the front.
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Front-of-pack labeling would address that problem. The FDA is currently conducting consumer research to determine a proposed front-of-pack framework for U.S.-based products. Many other countries have already adopted such systems. Some provide information about the product overall, while others focus on specific nutrients. Different types of interpretive designs — such as grades, star ratings, stoplight colors, or warning labels — are used to make the information more accessible and easier to understand. The premise is simple and straightforward: consumers should know immediately whether a product is healthy.
While the approaches to front-of-pack labeling vary, the positive impact is consistent. A recent analysis of more than 100 studies between 1990 and 2021 found that overall grade scores, traffic light colors, and nutrient/health warnings would each be effective at bolstering consumer understanding, increasing purchases of healthier products, and cutting down on purchases of unhealthier items. Real-world data from other countries back up these findings. The implementation of mandatory nutrient warnings in Chile, for example, has spurred both healthier purchases by consumers and healthier formulations of products from companies. Early implementation results have been promising in other countries like the United Kingdom, France, and Australia, which have adopted similar policies. UNICEF has concluded that front-of-pack labeling “can be a powerful tool to safeguard children’s right to a healthier future.”
Given the evidence, it is puzzling that some members of the food industry appear to oppose front-of-pack nutrition labeling. A 2023 national survey finds that 75% of U.S. consumers support mandatory front-of-pack labeling, including strong majorities across political affiliation, age range, education and income level, gender, race/ethnicity, and households with and without children.
Food and beverage companies eager to preserve market share shouldn’t have trepidation. Evidence shows customers are seeking healthier products and will reward companies offering products that meet their needs. One recent survey found that nearly 80% of consumers in the U.S. agree that nutritious foods are good for health and can reduce the risk of illness and disease. A 2015 study found that lower-calorie foods and beverages can drive higher sales growth at supermarkets. Protecting health and increasing market share need not be mutually exclusive.
Millions of families face real barriers to healthy, affordable foods and beverages. While it won’t solve all of these challenges, front-of-pack labeling would make it easier and faster for all consumers to make healthier choices, regardless of their income level or neighborhood. An interpretive design that is rooted in science, responsive to consumer needs, easy to understand, and required to appear on all packaged food products would be a potential game-changer for equitable health and could transform the landscape of products we see on shelves.
When the regulations implementing the Nutrition Labeling and Education Act were finalized, HHS Secretary Sullivan said, "American consumers are the winners.” Front-of-pack nutrition labeling presents the opportunity for an even bigger win. With the help and support of food and beverage companies, a healthier future is within our grasp.
Nancy Brown is the chief executive Officer of the American Heart Association