Making Sense of Food Labels

by Liz Friedrich, MPH, RD, LDN

The relationship between diet and health is complex, and our understanding of it is constantly evolving. For the consumer, though, it can be difficult to keep up with all the latest news, as best-selling books tout specific foods to eat and avoid and new studies seem to come out every week. The Nutrition Labeling and Education Act (NLEA) of 1990 was designed to help people sort through this often-­contradictory barrage of nutrition messages. The act requires most foods to list nutrition facts on their labels and also authorizes food manufacturers to make “nutrient content claims” and “health claims” for their products. The US Food and Drug Administration (FDA) implements the act’s provisions. Still, some confusion remains: What do all those numbers on the label really mean? What is the “percent daily value”? Can you believe the label that claims “this food may help prevent heart disease”? This article will take a closer look at some of the more commonly misunderstood features of food labels.

Nutrition 101

Before examining the label, it is important to understand the basics of good nutrition. The label will mean more to you if you know what you are looking for. Use the following guidelines to help you become a healthier eater — and a more informed label-reader:

  • Aim for variety and moderation in your food intake. Choose fruits, vegetables, whole grains, dairy products or ­calcium-fortified soy products, and protein sources such as meat, beans, eggs, or nuts daily. Try not to think of foods as “good” or “bad,” because most foods (with a few exceptions) do have some nutritional value, even if they are high in some undesirable nutrients.
  • Carbohydrates, protein, and fat all provide the body with calories. Most adults require 1,800 to 2,000 calories daily to maintain their weight. Some may require more or less, depending on their weight, age, health status, and fitness level.
  • Protein needs vary depending on body weight and medical status. Most people have no trouble getting enough protein.
  • Even healthy adults should limit their intake of fat (of all kinds), saturated fat, trans fat, cholesterol, and sodium because of these nutrients’ connection to heart disease. Those with heart disease should be extra careful about their intake of fats and sodium.
  • Everyone should limit added sugar, which has no nutritional value and can cause dental cavities and weight problems. Natural sugars found in fruits and vegetables are not considered added sugars.
  • Choose whole over refined grains when possible. See Whole Grains for a list of some alternatives.
  • Plentiful amounts of vitamins A and C, calcium, iron, and fiber are important to good health in a variety of ways and may help prevent some diseases.

The Nutrition Facts panel

The most important feature of a food label is the Nu­trition Facts panel, the well-known table of ingredients and nutrient amounts printed on most packaged foods. (See a Sample Nutrition Facts Panel.) The Nutrition Facts panel was designed to help people eat less of nutrients that are considered unhealthy, including fat, saturated fat, trans fat, cholesterol, sodium, and sugar. It can also be used to choose more of those nu­trients that promote good health, such as dietary fiber, vitamin A, vitamin C, calcium, and iron. Protein is listed on the panel but is not usually a major focus because lack of protein is not thought to be a health problem for most adults and children over 4 years of age.

To make label reading really meaningful, focus on two or three nutrients on the Nutrition Facts panel that are important to you, recommends Robin Plotkin, RD, LD, a culinary and nutrition consultant based in Dallas, Texas. Narrowing your focus will make it easier to use the information to your advantage. For example, if you are a postmenopausal woman, you might focus on calories, fiber, and calcium. If you are a man with heart disease, you might be most concerned with calories, fat, and sodium. If you are being treated for a diet-related medical condition, a registered dietitian (RD) can help evaluate your nutrition needs and teach you to focus on the key nutrients that will be most helpful to your situation.

Serving size. When asked by consumers what is most important on the Nutrition Facts label, the overwhelming response from registered dietitians is “serving size.” Shoppers tend to ignore this critical information, but it is very important, especially for those who are watching their calorie or fat intake. You’ll see the serving size and number of servings per container listed at the top of the Nutrition Facts panel. All nutrient amounts listed below the serving size are the amounts per one serving. If you don’t focus on the serving size, you might be taking in more nutrients than you realize. This is a real concern if you are eating (or drinking) foods that are high in calories, fat, or sugar. For example, check the label on a 20-ounce bottle of cola. Although it is usually assumed to be one serving, it is really two-and-a-half servings of soda and contains 250 calories and virtually no nutrients.

A big advantage of the Nutrition Facts panel is that serving sizes are expressed as common household measures (cups, tablespoons, teaspoons), which makes it easier for a consumer to know how much to eat.

Unfortunately, the serving sizes on food labels are not always the same as the portion sizes that are sanctioned by the US Department of Agriculture in its ChooseMyPlate nutrition guide. ChooseMyPlate recommends measuring portions of foods such as meats and beans in terms of ounces. This makes it difficult to compare ChooseMyPlate portions with the serving sizes on food labels. ChooseMyPlate does recommend standard household servings for fruits, vegetables, milk, and oils. Suggested intake for these foods can be more easily compared with the information on the Nutrition Facts panel.

Percent daily value. The Nutrition Facts panel not only lists the amounts of nutrients per serving, it also records the “percent daily value” of these amounts. The total daily recommended amount of any nutrient is calculated based on a diet of 2,000 calories a day, and the percent daily value is the percentage of that total value in one serving of any particular food. On some Nutrition Facts panels, you can find the total daily recommended values of several nutrients listed near the bottom of the panel. These recommendations are for the daily intake of total fat, saturated fat, cholesterol, sodium, potassium, total carbohydrate, and dietary fiber and are listed for both a 2,000- and a 2,500-­calorie diet. According to these recommendations, a person on a 2,000-calorie diet should aim to take in 300 g of total carbohydrate, 25 g of dietary fiber daily, and less than 65 grams (g) of total fat, less than 300 milligrams (mg) of cholesterol, and less than 2,400 mg of sodium. Depending on your age, calorie needs, or specific health condition, your nutrient needs may be higher or lower than the values listed.

According to the FDA, a 20% daily value in one serving of any food is considered high, and a 5% daily value is considered low. Your goal is a low intake of fat, saturated fat, trans fat, cholesterol, sugar, and sodium and a high intake of healthful nutrients such as fiber, vitamin A, vitamin C, calcium, and iron. Because much of eating healthfully is a trade-off, you probably eat some foods that are higher or lower in some nutrients than is recommended. That’s not usually a problem if you are nutrition-conscious most of the time. As a matter of fact, if you focus too much on keeping your intake of healthful nutrients high and/or your intake of fats, sodium, and sugar low, you may find yourself eliminating many foods that have a place in a healthy diet.

To make this concept easier to understand, look at this Sample Nutrition Facts Panel. (Notice that on this panel, from a box of cereal, the percent daily values are listed both for the cereal alone and for the cereal with milk added.) You’ll see that one serving of the breakfast cereal provides 5 grams of dietary fiber, which is 18% of the percent daily value for fiber. Check out the total fat content of this cereal. It is 4% of the percent daily value. Now look at the sodium content. The percent daily value of sodium in this cereal (without milk) is 10%. This is a reasonable amount of sodium, neither low (5%) nor high (20%), particularly when you consider that this cereal is a healthful choice because it is fairly high in fiber and very low in fat.

Can I believe those
health claims?

Have you ever wondered if you can believe the health claims that are found on some food labels? It turns out that you can, provided you read them carefully and understand their limitations. Health claims fall into one of two categories: “authorized” or “qualified.”

To be “authorized,” a health claim must relate a particular food or ingredient to a particular disease. The 1990 NLEA, which introduced health claims, says that manufacturers wanting to make a health claim must submit evidence supporting it to the FDA, and if the FDA is satisfied that the relationship is scientifically significant, the claim is allowed. A 1997 law, the Food and Drug Administration Modernization Act, provides a second way for the FDA to approve a health claim: The claim must be submitted to the FDA and it must be based on an authoritative statement of the US government or the National Academy of Sciences. In either case, authorized health claims can only use “may” or “might” in discussing the food/disease relationship. Also, they are only allowed to discuss disease risk — no food can claim to cure a disease. And the claim must make it clear that other factors also influence risk. A possible authorized health claim could read: “While many factors are associated with high blood pressure, a diet low in sodium may reduce the risk of this disease.”

As of March 2011, authorized health claims are allowed for the relationships between the following food ingredients and medical conditions:

  • Calcium and osteoporosis — and calcium, vitamin D, and osteoporosis.
  • Fat and cancer
  • Saturated fat and cholesterol and the risk of
    coronary heart disease
  • Fiber-containing grain products, fruits, and
    vegetables and cancer
  • Fruits, vegetables, and grain products that contain fiber and the risk of coronary heart disease
  • Sodium and high blood pressure
  • Fruits and vegetables and cancer
  • Folic acid and neural tube defects
  • Dietary sugar alcohol and tooth decay
  • Soluble fiber from certain foods and the risk of coronary heart disease
  • Soy protein and the risk of coronary heart disease
  • Plant sterol/stanol esters and the risk of coronary heart disease
  • Whole-grain foods and the risk of heart disease and some cancers
  • Potassium and the risk of high blood pressure and stroke
  • Low saturated fate, cholesterol, and reduced risk of heart disease

For each authorized claim, the FDA defines how much of a nutrient must be in a food to make the claim. For example, to carry a “calcium and osteoporosis” claim, the food must contain 20% or more of the percent daily value for calcium per serving. If a food label states “this food may help prevent osteoporosis,” the food is a good source of calcium.

“Qualified” health claims aren’t the result of legislation but came into being as part of the FDA’s 2003 Consumer Health Information for Better Nutrition Initiative. These kinds of claims are allowed when the scientific evidence is not conclusive, so long as the product’s label includes a disclaimer or otherwise “qualifies” the claim. The following is an example: “Some scientific evidence suggests that consumption of antioxidant vitamins may reduce the risk of certain cancers. However, the FDA has determined that this evidence is limited and not conclusive.” Qualified health claims are rather controversial. Many health and nutrition professionals believe that they make things more confusing for consumers and that some claims might even need to be revoked if new evidence shows that they can’t be validated. As you read qualified health claims, keep their limitations in mind.

(Dietary supplements, such as vitamins, can also use health claims as long as they meet the FDA’s requirements. Don’t confuse these health claims with the “structure/
function” claims often found on supplement labels. Examples of structure/function claims are “calcium builds strong bones” and “antioxidants maintain cell integ­rity.” This type of claim does not require premarket approval from the FDA — the manufacturer is responsible for ensuring the claim’s accuracy and truthfulness. The claim must be accompanied by a statement saying that the FDA has not evaluated the claim and that the supplement is not in­tended to “diagnose, treat, cure or prevent any disease.”)

Other label claims

What about claims that a food is “light” or “reduced”? There are also guidelines in place for using these and other “nutrient content claims” on food labels. If a label calls a food “light,” the food must conform to the FDA’s definition of that term. The Guide to Nutrient Content Claims on Food Labels gives a brief summary of terms that are allowed by the FDA and an example of each.

What’s in my food?

Also on the food label is a list of ingredients. The ingredient list tells consumers exactly what they are eating. This is especially important for those with food allergies or intolerances. It is also of interest when determining whether a product contains what has become the biggest buzzword in nutrition: “whole grain.” The FDA has provided guidance to manufacturers as to what constitutes a whole grain but has not yet passed a regulation that requires specific wording on food labels to help identify whole grains. In the meantime, dietitians encourage consumers to choose whole grains. (see Whole Grains) For maximum health benefits, choose foods that have whole grains near the top of the ingredient list — the closer an ingredient is to the top of the list, the more of that ingredient is in the product. If you look at the ingredient list on the cereal label on this page, you’ll note that whole oat flour is the first ingredient listed, whole wheat flour the second. That’s a good indication that this cereal is rich in whole grains. Information such as this, along with the wealth of other information on the label, helps you choose wisely when it comes to what you eat.

Last Reviewed November 8, 2012

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Liz Friedrich is a nutrition and health promotion consultant based in North Carolina

Statements and opinions expressed on this Web site are those of the authors and not necessarily those of the publishers or advertisers. The information provided on this Web site should not be construed as medical instruction. Consult appropriate health-care professionals before taking action based on this information.

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