1. THE NUTRITION FACTS LABEL Blakeley Denkinger, MPH, RD, CSSD Nutrition Assessment and Evaluation Team, Nutrition Programs Staff Office of Nutrition, Labeling, and Dietary Supplements Center for Food Safety and Applied Nutrition Food and Drug Administration

2. Points to cover Background –U.S. Nutrition Policy –The Food Label The Nutrition Label –Serving Size and Calories –Nutrients to limit or get enough –The footnote –The %DV –Supplement Facts Label Claims Educational Materials

3. Background – U.S. Nutrition Policy Dietary Guidelines for Americans (HHS and USDA) Food Guidance System (USDA) The Nutrition Label (FDA)

4. Nutrition Labeling and Education Act of 1990 Objectives Clear up consumers’ confusion about food label Aid consumers in making healthy food choices Encourage product innovation by giving manufacturers an incentive to improve the quality of the food and make more healthy food choices available to consumers

5. The Nutrition Facts Label

6. The Food Label Mandatory Elements –Identity of food –Ingredient statement –Amount of food in package –Name and place of business –Nutrition information Claims

8. One or Two Servings? Single Serving% DV Double Serving% DV2 Serving Size1 cup (228g)2 cups (456g) Calories250500 Calories from Fat110220 Total Fat12g18%24g36% Trans Fat1.5g3g Saturated Fat3g15%6g30% Cholesterol30mg10%60mg20% Sodium470mg20%940mg40% Total Carbohydrate31g10%62g20% Dietary Fiber 0g0% 0g0% Sugars 5g10g Protein 5g10g Vitamin A4%8% Vitamin C2%4% Calcium20%40% Iron4%8%

9. General Guide to Calories* 40 Calories is low 100 Calories is moderate 400 Calories is high *Based on a 2,000-calorie diet.

10. What is a Daily Value? Reference values that are used to assist consumers in understanding how nutrients fit into the context of the total daily diet Assist consumers in comparing nutritional values of food products 4 yrs and older

11. How are they set? Based on reference values such as the Recommend Dietary Allowances (RDAs) or on consensus statements such as the Dietary Guidelines. Most cases based on highest RDA for adult males from 1968 Based on a 2,000 kcal diet

12. Uses of %DV Comparison of products Nutrient content claims –10% of the DV -Good source –20% or more of the DV- Excellent or High Dietary trade-offs DVs are not individual goals for intakes

13. How the Daily Values relate to %DV NutrientDaily Values Total Fat65 g Saturated fatty acids 20 g Cholesterol300 mg Sodium2400 mg Potassium3500 mg Total carbohydrate 300 g Fiber25 g Protein50 g Vitamin A5000 IU Vitamin C60 mg Calcium1000 mg Iron18 mg Vitamin D400 IU Vitamin E30 IU Folate400 µg 33 nutrients

14. Quick Guide to % DV 5% DV or less is Low Limit these Nutrients Get Enough of these Nutrients 20% DV or more is High

15. Get Enough of These Nutrients Choose foods with the higher % DV for these nutrients

16. Limit These Nutrients Select foods that are lowest in saturated fat, trans fat, and cholesterol to help reduce the risk of heart disease Limit sodium to reduce your risk of high blood pressure

17. No % Daily Value Trans Fat Sugars Protein

18. Nutrition Label: Voluntary Nutrients Calories from saturated fat Polyunsaturated fat Monounsaturated fat Potassium Soluble Fiber Insoluble fiber Sugar Alcohol Other Carbohydrate Other vitamins and minerals for which RDIs have been established Beta-carotene (as % of Vitamin A)

19. Read the Nutrition Facts Label For Total Sugars Plain YogurtFruit Yogurt

20. Look at the Ingredient List for Added Sugars Plain Yogurt INGREDIENTS: CULTURED PASTEURIZED GRADE A NONFAT MILK, WHEY PROTEIN CONCENTRATE, PECTIN, CARRAGEENAN. Fruit Yogurt INGREDIENTS: CULTURED GRADE A REDUCED FAT MILK, APPLES, HIGH FRUCTOSE CORN SYRUP, CINNAMON, NUTMEG, NATURAL FLAVORS, AND PECTIN. CONTAINS ACTIVE YOGURT AND L. ACIDOPHILUS CULTURES

21. The Footnote

22. The Ingredient Statement Reminder: Ingredients are listed in Descending Order Of Predominance

23. Other ingredients: Gelatin, lactose, magnesium stearate, microcrystalline cellulose, FD&C yellow No. 6, propylene glycol, propylparaben, and sodium benzoate.

24. Label Claims

25. Types of Claims Health Claims –Authorized (Significant Scientific Agreement, SSA) –Qualified Health Claim –Food Drug and Modernization Act (FDAMA) Structure/Function Claims Nutrient Content Claims –FDAMA

26. Health Claim “Health Claim” is an expressed or implied statement in food labeling about the relationship of a food substance to a disease or health- related condition. (21 U.S.C. 343(r)(1)(B); 21 CFR 101.14(a)(1)) Not just “any claim about health” Require Pre-approval by FDA Can be used on conventional foods and dietary supplements

27. Selected Authorized Health Claims (Meet a significant scientific agreement standard) Calcium and osteoporosis Dietary fat and cancer Dietary saturated fat and cholesterol and heart disease Fiber containing grain products, fruits and vegetables (certain foods) and cancer Fruits, vegetables and grain products (soluble fiber) and heart disease Non-cariogenic sweeteners and dental caries Soy protein and heart disease Plant stanols / sterols and heart disease

28. What About Claims Not Meeting SSA Standard? Qualified Health Claims are based on scientific evidence that is credible but that does not meet the SSA standard include qualifying language to prevent consumers from being misled about the level of support for the claim considered under FDA’s exercise of enforcement discretion (not authorized by regulation)

29. QHCs: Heart Disease –Omega 3 fatty acids (EPA/DHA) –Monounsaturated fatty acids from olive oil –Unsaturated fatty acids from corn oil –Walnuts –Nuts –B vitamins and vascular disease QHCs: Cancer –Calcium and colon/rectal cancer –Green tea and breast/prostate cancer –Selenium and certain cancers –Antioxidant vitamins and certain cancers –Tomato and certain cancers Qualified Health Claims

30. Model Claim Statements (QHC) Monounsaturated Fatty Acids from Olive Oil and Coronary Heart Disease (Oct. 2004) “Limited and not conclusive scientific evidence suggests that eating about 2 tablespoons (23 grams) of olive oil daily may reduce the risk of coronary heart disease due to the monounsaturated fat in olive oil. To achieve this possible benefit, olive oil is to replace a similar amount of saturated fat and not increase the total number of calories you eat in a day. One serving of this product contains [x] grams of olive oil.”

31. Structure/Function Claims Describe the role of a nutrient or dietary ingredient intended to affect normal structure or function in humans –“Calcium builds strong bones” –“Lycopene promotes prostate health” May characterize the means by which a nutrient or dietary ingredient acts to maintain such structure or function –“Antioxidants maintain cell integrity” –“Fiber maintains bowel regularity” http://www.fda.gov/Food/LabelingNutrition/LabelClaims/StructureFunctionClaims/default.htm

32. Nutrient Content Claims –Describe the level of a nutrient or a dietary substance –Terms include free, high, low –Comparative claims more, reduced, lite –Healthy –Simple amount or percent claims

33. Absolute Claims Free: depends on nutrientFree: depends on nutrient –Fat: < 0.5g per RACC and labeled serving –Sodium: < 5mg per RACC and labeled serving Low: depends on nutrientLow: depends on nutrient –Fat: ≤ 3g per RACC –Sodium: ≤ 140mg per RACC

34. Absolute Claims Good source: 10%-19% of Daily Value per RACCGood source: 10%-19% of Daily Value per RACC Excellent source: ≥ 20% of Daily Value per RACCExcellent source: ≥ 20% of Daily Value per RACC

35. Relative Claims Lite/Light – a number of definitions:Lite/Light – a number of definitions: –50% reduction in fat content –1/3 reduction of calories –50% reduction in sodium *A reference food must be a food or group of foods that are representative of the same type as the food bearing the claim. The type of food used as a reference food must be identified on the label as part of the accompanying information.*A reference food must be a food or group of foods that are representative of the same type as the food bearing the claim. The type of food used as a reference food must be identified on the label as part of the accompanying information.

36. Relative Claims Reduced (lower, fewer):Reduced (lower, fewer): –at least 25% reduction for the nutrient per RACC compared to an appropriate reference food* More (added, extra):More (added, extra): –at least 10% more of the Daily Value for a nutrient per RACC than an appropriate reference food*

37. Criteria for Use of “Healthy” Criteria for Use of “Healthy” (September 29, 2005) Individual Food (RACC is > 30 g) Total Fat3 g or less/RACC (low) Saturated Fat1 g or less/RACC & 15% or less calories (low) Sodium*480 mg or less/RACC & per labeled serving Cholesterol60 mg or less/RACC & per labeled serving Beneficial Nutrients At least 10% RDI or DRV per RACC for one or more of vitamins A, C, iron, calcium, protein, or fiber *Seafood/game meats; main dishes different requirements

38. Educational Materials

39. Spot the Block FDA/Cartoon Network public education campaign to encourage "tweens," youth ages 9 to 13 to use the Nutrition Facts information on the food labels. What is the “The Block”? The Nutrition Facts Label on the food package http://www.cfsan.fda.gov/~dms/spotov.html http://www.cartoonnetwork.com/promos/200804_fda/index.html

40. Nutrition Facts Label

41. The Road to a Healthy Life

43. For More Information For More Information www.cfsan.fda.gov/~dms/lab-gen.html Power of Choice Healthy Lifestyle Program Nutrition Information for Raw Fruits, Vegetables, and Fish Nutrition Facts Label brochure Make your Calories Count Spot the Block